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DEPARTMENT OF EDUCATION. 



MEDICAL BRANCH. 



ANNUAL REPORTS 



OF THE 



PRINCIPAL MEDICAL OFFICER 



FOR THE YEARS 1918-1919. 



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DEPARTMENT OF EDUCATION. 



MEDICAL BRANCH. 



ANNUAL REPORTS 



OF THE 



PRINCIPAL MEDICAL OFFICER 



FOR THE YEARS 1918-1919. 



14833— A 



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°°eUMtHTB OrVJSlON 



TABLE OF CONTENTS. 



Part I. — Medical Branch — Annual Reports, Nos. 6 and 7, 1918 and 1919. 

PAGE. 

Introduction — Extracts from Minister's Report, 1919 5 

A. — Extracts from the Reports Nos. 6 and 7 of the Principal Medical Officer — 

1. The Physical Well-being of the School Child 7 

2. Medical Inspection and Treatment ... 8 

3. Illustrations of the Work of the Travelling Dental Clinics ... ... 13 

4. Hygienic Conditions in School ... ... ... ... ... ... 13 

5. Defects of Speech, 1919 15 

6. Communicable Diseases (by the late Dr. C. Savill Willis) ... 16 

7. The Travelling Hospital 20 

8. Report of the School Nurses ... ... ... ... ... 31 

9. Conclusion ... ... ... ... ... ... ... ... ... 33 

B. — Statistical Tables : — 

1. Details of Medical Inspection ... ... ... ... 34 

2. Totals of Children found Defective, and those who obtained Treatment 

as a result of Medical Inspection ... ... ... 36 

3. Particulars of Defects and Treatment for each Scheme ... 40 

3a. Percentage of Children Defective and Treated ... ... 41 

4. Travelling Hospital 42 

5. Numbe*r of Schools Medically Inspected ... ... ... ... ... 45 

6. Medical Examinations for Admission to the Teaching Service and Train- 

ing College ... ... ... ... ... ... ... ... ... 45 

6a. Total Defects and Percentages deferred or rejected, 1917, 1918, & 1919 46 

7. Particulars of Children with Unsatisfactory Hair Conditions ... ... 47 

8. Vaccination Returns ... ... ... ... ... ... 47 

9. Particulars of Work performed by Department's Dental Officers 48 

10. Ophthalmic Clinic 48 

11. Defects of Speech - 49 

12. Aboriginal Schools ... ... ... ... ... ... ... ... 49 

13. Infective Diseases and Summary ... ... ... ... ... ... 51 

13a. Percentage Number of Children affected by each Disease ... ... 55 

Part II. — School Anthropometry. 
Physical Condition of Children attending New South Wales Public Schools — 

1. Foreword ... ... ... ... ... ... ... ... ... ... 56 

2. The Scientific Study of Malnutrition in School Life 60 

3. Rate of Growth of Australian Children (by Dr. Harvey Sutton, Principal 

Medical Officer) 66 

4. Statistics of Height and Weight for New South Wales Children, with 

Graphs. (Report compiled by Mr. F. A. Mecham, Statistical Officer, 

Education Department) ,„ ... ... ... ... ,,, ... 69 



EXTRACT FROM THE MINISTER'S REPORT, 1920. 

14th September, 1920. 
During the year 1919, the Medical Branch sustained a very severe loss 
in the death of Dr. C. Savill Willis, by whose whole-hearted and un- 
flagging efforts the framework of a complete scheme of School Medical 
Services was organised and established on a firm foundation. 

His place has been taken (1st March, 1920) by Dr. Harvey Sutton, 
from the Education Department, Melbourne. 

The second round of Medical Inspection is now complete. 
During 1917-8-9 201,032 children have been examined, and 128,685 
have been notified for treatment. 

The war scarcity of Medical Practitioners depleted our staff, 
while the great influenza epidemic of 1918-1919 caused schools to be 
closed and School Doctors and School Nurses to be withdrawn on 
occasion for special epidemic work. In spite of these handicaps, the 
Branch has not relaxed its control of the health of school children. The 
regular work, both medical inspection and medical and dental treatment, 
in rural and country districts, has been fully maintained, though short- 
ness of staff has occasioned a certain falling-off in the work in metropolitan 
schools. 

The School Medical Services fall naturally under two headings 
(1) Inspection, (2) Treatment. 

Inspection by School Medical Officers is now accepted as an 
essential part of the educational control of children. Its function is 
to test children and recognise defects which interfere with their health 
and their educational progress. The majority of the defects (apart 
from bad teeth) are quite unknown to parents, and in dental defects 
the completest ignorance exists as to the imperative necessity of conserving 
the permanent teeth, especially the first permanent molars appearing 
at 6 years of age. 

So numerous are these defects that 60 per cent, at least of children 
require notification to parents — a percentage agreeing with remarkable 
accuracy with the percentage of recruits rejected as unfit for active 
service because of these very defects or their sequels. 

The specialisation of certain officers for the long-desired attack 
on the problem of the feeble-minded (the most dangerously unfit class 
in society), and on the supervision of the health of High School girls 
and of Women Students at the Teachers' College, has been begun this 
year. This reduction of the staff available for Medical Inspection, 
together with the natural increase of school population, has made neces- 
sary the appointment of eight Medical Inspectors, chiefly for metro- 
politan work. So far, only six are provided for in the vote. Medical 
Inspection, as applied in metropolitan areas, is at its maximum value 
to children, owing to the valuable facilities for special treatment of eye, 
ear, nose, and throat, open to children at our great Public Hospitals, 
and also because, compared to country children, a far greater proportion 
(at least 30 per cent.) possess medical defects requiring treatment. The 



6 

need for recognition then is greater; trie outside provision is still greater; 
and inspection, therefore, more in demand, and more complete in results. 

Consideration of these facts, now established over hundreds of 
thousands of children in New South Wales, has driven home the logical 
corollary of inspection — the provision of treatment. Inspection is 
sometimes criticised as failing in this provision, but its value. to a large 
number of children has been proved, for 40 per cent, of those notified 
to parents are attended to by the present existing agencies — the hos- 
pitals or the private doctor or dentist. This alone must be regarded 
as an immense step in the right direction. 

The needs of the remainder remain untouched by ordinary 
inspection and the unaided effort of the parents. In 1914, treatment 
schemes were introduced, with excellent results. Travelling Dental 
Clinics treat 14,000 country children yearly, and the Metropolitan School 
Dental Clinic 4,000 city children per year, while the Travelling Hospital 
treats as many as 500 eye cases in rural districts each year. But twice 
as much dental work is urgently required if the protection of the early 
permanent teeth (the basis of dental righteousness) is to be assured to 
our children. 

It is agreed by both medical and dental professions that Travelling 
Dental Clinics are a desirable and urgently necessary State provision; 
and the Medical Congress similarly supports Travelling Ophthalmolo- 
gists in outlying areas. 

To put this in operation, an additional staff of at least three 
Travelling Hospitals, including Ophthalmologists, and ten Travelling 
Dentists and Dental Assistants, is required, at a cost of £7,500 and 
£10,000 respectively, to provide for salaries of staff, travelling allowances 
and fares, initial equipment and running costs. Considering the amount 
of work done, and the great distance to be travelled, this provision, 
which costs approximately 10s. 6d. per head of each child medically 
and dentally treated, and 7s. 6d. for dental treatment, must be regarded 
as a first-class investment for the State, as it safeguards, in a way no 
other agency can, the health of our chief asset — the growing generation 
of children in school. 

Only part of this provision for this expansion in treatment is 
arranged for 1921 on the Estimates, one Ophthalmologist and three 
Travelling Dental Clinics only being possible on the vote allowed; vet 
every postponement of provision of this need — a provision advised by 
every expert, and clamoured for by parents all over the State — simply 
adds so many more to our unfit classes of adults. The war test showed 
the importance to the nation of Al class adults, and the menace and 
weakness of the large numbers of unfit C3 classes. The lesson was a 
bitter one, learnt in the hard school of experience. The State must see 
to it that the lesson learnt then shall be utilised for the benefit of the 
rising generation, on whose shoulders the financial burden of the war 
must largely rest, and a Peace Campaign of physical fitness and efficiency 
(the basis of the badly-needed increased production) inaugurated in the 
best way — the school way of complete physical and mental development 
of every child. 

Details of the present work of Medical Inspection will be found in 
the Medical Report, which will be published separately. 



PART I.— EXTRACTS FROM THE SIXTH AND SEVENTH 
ANNUAL REPORTS OF THE PRINCIPAL MEDICAL 
OFFICER. 

THE SCHOOL CHILD'S PHYSICAL WELL-BEING. 

That the Education Department is fully alive to the necessity 
of children's physical welfare, as well as their mental equipment, is 
amply proven by the amount and scope of work carried out by the 
School Medical Service since the reorganisation of that particular branch 
early in 1913. In that comparatively short space of time, a Medical 
Inspection has been conducted in every school in the State, even unto 
its remotest confines—as far north as Tweed Heads and Hungerford; 
as far south as Eden and Albury ; as far west as Milparinka and Broken 
Hill. At the present time the second " round" of inspections has been 
completed, and the scheme aims to reach every child three times in its 
school life. 

This reorganised scheme commenced with a professional staff of 
ten full-time Medical Officers, including the Principal Medical Officer, 
the late Dr. C. Savill Willis, and five School Nurses; and in the last 
three months of that year, 25,000 odd children were examined and 
reported on by the Doctors. 

It soon became apparent, however, that Medical Inspection only 
was of comparatively little service unless it resulted in an appreciable 
proportion of defective children obtaining treatment. The fact that 
59 per cent, of the children examined in that three months (September 
to December) required treatment in one form or another, meant nothing 
unless there was certain knowledge that a large number of them was 
going to receive the necessary treatment. 

The problem of deciding what treatment facilities were required 
and then of providing those facilities, bristled with difficulties, but by 
1916 the following Treatment Schemes were going " full speed ahead" : — 

One Travelling Hospital, which visits districts far removed from 
what may be called " the haunts of civilisation," carrying 
medical and dental aid to children who probably would never 
receive such a boon in ordinary circumstances. As far as is 
known, this Travelling Hospital is unique in the history of 
School Medical Services throughout the world. 

One Travelling Ophthalmic Clinic. — Following Medical Inspection, 
this Clinic visited the large country towns, into which children 
from outlying districts journeyed to obtain refractive and other 
treatment for eye defects. 

Six Travelling Dental Clinics, visiting similar centres after Medical 
Inspections, and treating the teeth conditions of school children 
from surrounding districts. 

One Metropolitan Dental Clinic, in Sydney, to treat the children 
of metropolitan schools examined and found to require dental 
treatment. 



A General Treatment Clinic was established in Sydney to meet 

the needs of children requiring other than dental attention, but 

was later closed on some of the Metropolitan Hospitals agreeing 

to take over the work. 

At the present moment, engaged on the medical examination 

and treatment of children, apart from other branches of work carried 

out by the School Medical Service, there is a professional staff of — 

11 Medical Officers, 

12 Dental Officers, 

6 Dental Assistants, 

7 School Nurses, 
exclusive of several vacancies. 

Public appreciation .of these Treatment Schemes is becoming 
more and more marked as experience proves their benefits. To dip 
briefly into statistics, in 1918 74,052 children were medically examined, 
of whom 47,250 were found to have some defects requiring treatment. 
Of this latter number, 25,367 were treated by all sources; and 7,501 
out of the 25,367 passed through the hands of this Department's Doctors 
and Dentists. Of course, 7,501 does not nearly represent the children 
actually treated by the various Clinics and Travelling Hospital last year, 
as that total reached the remarkable number of 21,098. 

The work so briefly outlined very inadequately conveys all that 
the School Medical Service stands for in the scope of the Education 
Department's activities, but even this is a magnificent monument to the 
memory of its chief designer and promoter, the late Dr. C. Savill Willis- 
It was his life-work, in which he spent himself ungrudgingly and 
untiringly. Possibly only Dr. Willis knew what it cost him of mental 
and physical stress and strain to plan and put on to a successful basis 
such a stupendous scheme — so far-reaching in its benefits to the children 
and the State. The consideration that such is usually the lot of the 
pioneer in any efforts making for the betterment of the people, does not 
lessen the burden on the pioneer's shoulders. And to have accomplished 
all this within six shor!; ye.irs is a truly noble work, and one that future 
generations will reap fuller benefit from even than do we of this generation. 



MEDICAL INSPECTION. 

The summary gives the mass totals of inspection work and its 
effect in treatment. 

The year 1919 was greatly interfered with by closure of schools 
during the influenza epidemic. In 1918 74,052 children were medically 
examined at 860 schools; in 1919 59,098 children at 791 schools. These 
figures do not include the Treatment Clinics, except the Travelling 
Hospital, which carried out a proper inspection of 4,049 and 3,354 
children in 1918 and 1919 respectively, the schools visited numbering 
151 and 100. 

The net totals for the ordinary medical inspection are : — 1918, 
70,003; and 55,745 in 1919; and of these 52-2 and 54-2 per cent, were 
notified for defects requiring treatment. 



9 



In addition to the above, examinations were conducted of entrant 
Teachers, and also special visits to Aboriginal Schools. 



Year. 


Candidates 

for admission 

to the 

Teaching Service. 

Number examined. 


Number passed 
at once. 


Number deferred 

for treatment 

(medical, surgical, 

dental) and 

subsequently passed. 


Number 

rejected as 

physically unfit. 


1918 
1919 


556 
606 


269 
290 


265 
297 


22 
19 



Year. 


Number of 
Aboriginal Schools 
visited. 


Number cf 

Native Children 

examined. 


Number of 
Children sufficiently 
defective to need 

treatment. 


Percentage Number 
of childi en 
defective. 


1918 
1919 


5 
14 


65 
202 


35 

98 


53-8 

48-5 



While attendance at school is compulsory the Medical examination 
remains at present optional. Occasional refusals by parents are met with # 
but these are counterbalanced by the keenness of the great majority, 
As a test of the parents' attitude reference may be made to the average 
daily attendance , which represents the practical result of compulsion, 
and represents every available child, with the exception of the metropolis, 
1918. The number of children of public schools passing through the hands 
of the Medical Officer exceeds the daily average attendance, and approxi- 
mates to the net yearly enrolment, a very gratifying result. The 
Travelling Hospital practically meets with no refusals, and, indeed, the 
very greatest desire for the attention offered. 



SUMMARY 0? THE RESULTS OF MEDICAL INSPECTION FOR THE 

YEARS 1918-19. 

. 

(The details will be found in Tables attached to this Report.) 
I. Public ScnooLS. 
(a) Metropolitan Area. 

Total number of children examined ... 

Number of children notified as suffering from physical defects 

Percentage number of children found suffering from physical 

defects sufficiently serious to require notification 
Number of children subsequently treated (including a 

number of children treated at the School Clinics) 
Percentage number of children treated 



(b) Large Country Towns. 
Total number of children examined ... 
Number of children notified as suffering from physical defects 
Percentage number of children found suffering from physical 

defects sufficiently serious to require notification 
Number of children subsequently treated (including a 

number treated by the Travelling Clinics) 

Percentage number of children treated 



1918. 


1919. 


24,030 


10,431 


15,206 


6,660 


63-2 


63-8 


8,116 


4,494 


53-3 


67-4 


24,494 


23,776 


16,209 


15,650 


66-1 


65-8 


7,891 


7,498 


48-6 


47-9 



12,213 


14,683 


6,949 


9,294 


56-8 


63-2 


3,793 


5,002 


54-5 


53-8 



10 

(c) Small Country Towns and Villages. 

Total number of children examined (excluding those 
examined by the Travelling Hospital) 

Number of children notified as suffering from physical defects 

Percentage number of children found suffering from physical 
defects sufficiently serious to require notification 

Number subsequently treated (including a number treated 
by this Department's officers) ... 

Percentage number of children treated 



(d) All Public Schools Inspected. 

Total number of children examined (excluding those 

examined by the Travelling Hospital) 60,737 48,890 

Number of children notified as suffering from physical defects 38,364 31 ,604 
Percentage number of children found suffering from physical 

defects sufficiently serious to require notification ... 63.1 64-6 

Number of children subsequently treated (including a . 

number treated by this Department's officers) 19,800 16,994 

Percentage number of children treated 51-6 53-7 



II. Denominational and Private Schools. 
(a) Metropolitan Area. 

Total number of children examined ... 

Number of children notified as suffering from physical defects 

Percentage number of children found suffering from physical 

defects sufficiently serious to require notification 
Number of children subsequently treated (including a 

number treated at the School Clinics) 

Percentage number of children treated 



(b) Large Country Towns. 

Total number of children examined ... ... 

Number of children notified as suffering from physical defects 
Percentage number of children found suffering from physical 

defects sufficiently serious to require notification 
Number of children subsequently treated (including a 

number treated by the Travelling Clinics) 
Percentage number of children treated 



(c) Small Country Towns and Villages. 

Total number of children examined (excluding those 
examined by the Travelling Hospital) 

Number of children notified as suffering from physical defects 

Percentage number of children found suffering from physical 
defects sufficiently serious to require notification 

Number of children subsequently treated (including a 
number treated by this Department's officers)... 

Percentage number of children treated 



(d) All Denominational and Private Schools Inspected. 

Total number of children examined (excluding those 

examined by the Travelling Hospital) 9,266 6,850 

Number of children notified as suffering from physical 

defects 5,841 4,222 

Percentage number of children found suffering from physical 

defects sufficiently serious to require notification ... 63-03 61*6 

Number subsequently treated (including a number treated 

by this Department's officers) ... 3,286 2,434 

Percentage number of children treated 56*2 57-6 



2,863 


1,588 


1,884 


974 


65-8 


61-3 


988 


627 


52-4 


64-3 



4,504 


• 3,842 


2,764 


2,386 


61-3 


62-1 


1,588 


1,277 


57-4 


53-5 



1,899 


1,420 


1,193 


862 


62-8 


60-7 


710 


530 


59-5 


61-4 



11 

III. All Schools Inspected (Public, Denominational and Private Schools). 
*Total number of children examined (excluding those 

examined by the Travelling Hospital) ... 70,003 55,740 

Number of children notified as suffering from physical 

defects ... 44,205 35,826 

Percentage number of children found suffering from physical 

defects sufficiently serious to require notification ... 63-1 64-2 

fNumber subsequently treated (including a number treated 

by this Department's officers) 23,086 19,428 

Percentage number of children treated ... 52-2 54-2" 



IV. Travelling Hospital. 
Number of children examined 

Number of children found with defects needing treatment 
Percentage number of children found suffering from physical 

defects sufficiently serious to require treatment 
Number of children subsequently treated 
Percentage number of children treated 

A proportion of the children with more than one defect, and recorded as treated, did 
not obtain treatment for all their defects. 

Note. — In the above summary the figures do not include unsatisfactory hair 

conditions, which are given later on. 

• The number shown above as examined does not include those children examined by the staffs 
of the clinics, since the examinations in these cases were partial only. 

f Of the number shown as treated in the above summary, 5,411 in 1918, and 4,980 in 1919 were 
treated at the various school clinics. The remainder of the children treated at the school clinics is not 
included, as those were children who were either (a) medically examined the previous year, or (b) 
found to be defective by the staffs of the clinics. 

Reviewing the results of this Summary for 1918-19, it will be 

seen that : — 

The Total Number of Children treated for the years 1918-19 
was as follows : — 



4,049 


3,354 


3,045 


2,802 


75-2 


83-5 


2,281 


2,539 


74-9 


90-6 



1918. 1919. 



(1) The number of children treated as a result of ordinary 

school inspection was (5,411 by Clinics, and 17,675 
by outside agencies) 1918 ; 4,980 and 14,448 in 1919 

(2) The number of children treated in connection with 

the Travelling Hospital was ... 
In addition, the Metropolitan and Travelling Clinics 
also treated 

Total number of children treated ... 



The work done by Departmental effort, as contrasted with the 
treatment by outside agencies, is of interest. 



23,086 


19,428 


2,281 


2,539 


13,597 


8,940 


38,964 


30,907 



COMPARISON BETWEEN THE NUMBER OP CHILDREN TREATED BY THIS 
DEPARTMENT'S OFFICERS AND BY OUTSIDE AGENCIES. 

Not only does the Department already provide for the majority 
of those treated, but a large percentage of those treated only receive 
attention because of the stimulus parents are given by the notices sent 
by the medical branch, followed up in the metropolis by home visiting 
by the school nurse, and in the country by the educational effect of 
Travelling Clinics. 

Further, it shows that outside agencies at present only cope 
with a small proportion of the child population, and will need further 
supplementing to meet the needs demonstrated by medical inspection, 



12 



COMPARISON BETWEEN 1918, 1919, AND THE PREVIOUS FIVE YEARS. 



Y*ar. 



Number of 

Children 

Examined. 



Number of 

Children with 

Defects Needing 

Treatment. 



Percentage Num- 
ber of Children 
Defective. 



Number of 
Children Treated. 



Percentage Num- 
ber of Childrca 
Treated. 



1913 


25,G38 


1914 


70,323 


1915 


G2,G36* 


1910 


03,128 


1917 


55,556 


1918 


00,737 


1919 


48,890 



I. Public Schools. 




15,135 


59-0 


4,704 


40,187 


60-5 


14,030 


3G.590 


53-2 


1G.590 


35,873 


5G-8 


19,32$ 


31,033 


62 3 


18,098 


33,334 


63-1 


19,800 


31,004 


64-0 


10,994 



32-4 
30-5 
45 4 
53-8 
52 2 
51-0 
53-7 



II. Denominational and Private Schools. 



1914 


15,GG2 


10,173 


G4-9 


1,700 


107 


1915 


14,189 


8,549 


00-2 


2,777 


32 4 


1910 


9,790 


5,572 


5G-9 


3,2GG 


58G 


1917 


9,248 


5,714 


Cl-7 


3,311 


579 


1918 


9,200 


5,841 


03-03 


3,280 


50-2 


1919 


0,850 


4,222 


61-6 


2,434 


57-0 



III. All Schools (Public, Denominational and Puivate.) 



1913 


25,038 


15,135. 


59-0 


4,704 


32 1 


1914 


91,985 


5G,3GD 


01-2 


15,790 


280 


1915 


70,875 


45,019 


58-0 


19,307 


42-9 


191G 


72,918 


41,445 


5G-S 


22,592 


515 


1917 
1918 


G 1,804 
70 ; 003 


40,317 
44,205 


02 2 

63.1 
Qfi 1 


21,409 
23,036 


53 OG 
52 2 


1919 


55J40 


35,826 


04 2 


19,428 


54 2 



TREATMENT WORK CARRIED OUT BY THE OFFICERS OF THE SCHOOL 
MEDICAL SERVICE DURING 19.8 AND 1919. 

The number of children treated during the year by the Depart- 
ment's treatment scheme was as follows: — 



The Travelling Hospital treated ... 
The six Travelling Dental Clinics treated . 
The Metropolitan Dental Clinic treated . 
The Travelling Ophthalmic Clinic treated 



1918. 


1919. 


2,090 


2,454 


2,033 


11,290 


3,893 


2,462 


3,082 


102 



Total number treated by the Officers of the School 

Medical Service 21,098 



16,374 



Note —In 1918 tho above clinics treated 21,098 childien ; in 1919, 10,374 (travelling ophalmie 
clinic discontinued 31st Januaiy, 1919). 5,411 (1918), 4, 9S0 (1919) [see note at foot of table 2], we.e 
children who had been medically inspected by our doctors daring these years, and whose names 
were entered on the ttachers' lists as treated. These treitmmt? are included ia tables 2 and 3. The 
remaining 15,687 (191£), 11,394 (1919), include children who were examineJ in 1917 by our doctors, 
but a large majoiity are children who were not eximined by any doctor b.it presented themselves to 
the dentist for teeth examination an', treatment. 




No. 1. 

Shows the teeth to be badly in 
need of attention— the cavities in 
the teeth forming nests for the 
multiplication of micro-organisms, 
and for the fermentation and 
putrefaction of food-particles. In 
this case the gums were un- 
healthy, the teeth discolored, and 
several abscessed. 




No. 2. 

Teeth partly treated. 
The broken edges 
have been trimmed 
away and the cavities 
cleared of carious 
material. 





No. 3. 

Treatment completed. The gene- 
ral appearance of the mouth is 
greatly improved, the contour of 
each tooth restored ; and the lost 
tooth substance replaced by a 
durable material, which is an 
effective barrier against the pro- 
cesses which lead to decay. 



13 

COMPARISON BETWEEN THE NUMBER OF CHILDREN TREATED BY THIS 
DEPARTMENT'S OFFICERS AND BY OUTSIDE AGENCIES FOR THE YEARS 

1918 AND 1919. 

1918. 1919. 

f This Department's Officers treated 21,098 16,374 

The' outside agencies of the whole State (Hospitals, lodge 

doctors, private practitioners, dentists) only treated 17,866 14,533 

COST OF THIS DEPARTMENT'S TREATMENT SCHEMES. 

1918. 1919. 



Treatment Schemes. 

Travelling Hospital 
Six Travelling Dental Clinics 
Metropolitan Dental Clinic 
Travelling Ophthalmic Clinic 


Total cost for year 
(including salaries, 
allowances, drugs, 
cost of travelling, 
&c.) 

£ s. d. 
... 2,123 7 5 
... 5,017 5 2 
... 1,505 10 4 
... 960 10 3 


{Cumber of 
persons 
treated. 

2,281f 
12,033 

3,893 
3,082 


Total cost for year 
(including salaries, 
allowances, drugs, 
cobt of travelling, 
rent, &c ) 

£ s. d. 

1,987 3 1 

4,920 14 11 

1,610 13 10 

204 8 2* 


Number of 
perBong 
treated. 

2,539J 
11,296 
2,462 
162 


All. schemes 


...£9,606 13 2 


21,289 


£8,723 


16,459 



Note. — (1) Many of the children treated by the Travelling Hospital were treated 
for more than one defect. 

(2) The Travellling Ophthalmic Clinic was discontinued as from 31st January, 1919. 

* Includes arrears in salary to value of £125. 
+ 191 of these were treated by outside agencies. 
I 85 of these were treated by outside agencies. 

TRAVELLING DENTAL CLINIC. 

The attached series of photographs illustrate the kind of work 
being done in country schools by the Department's Travelling Dental 
Clinics. 

No. 1. — Shows the teeth to be badly in need of attention— the 
cavities in the teeth forming nests for the multiplication of micro- 
organisms, and for the fermentation and putrefaction of food-particles. 
In this case the gums were unhealthy, the teeth discolored, and several 
abscessed. 

No. 2.— Teeth partly treated. The broken edges have been 
trimmed away and the cavities cleared of carious material. 

No. 3. — Treatment completed. The general appearance of the 
mouth is greatly improved, the contour of each tooth restored; and 
the lost tooth substance replaced by a durable material, which is an 
effective barrier against the processes which lead to decay. 

Summary from Dentist's Report. 
Edna W. (aged 12) :— 

Scaling and cleaning. 3 Root fillings. 

6 Dressings. 3 Permanents extracted (6-year-old molars). 

9 Amalgam fillings. 3 teeth irremediable. 

2 Cement fillings. 8 teeth carious but remediable, including 

2 Nerve extractions. three mouth abscesses. 

5 Abscess treatments. Time — About three weeks (sixteen visits). 

L. S. Day, Operating Dentist. 

PERSONAL HYGIENE, 

The first duty of the School Hygienist is the democratizing of 
cleanliness. The obvious need and first claim is for the treatment of 
defects, and medical inspection schemes which do not make this provision 
must be regarded as incomplete. But this does not say, as is often 
affirmed, that they are useless. Indeed, the reverse is the case. Not 
only is treatment by the regular agencies greatly increased, but cleanli- 
ness has been brought into a far more intimate association with the 



14 



school. Medical inspection has worked a marvellous change in cleanli- 
ness of the hair, with freedom from the head-louse and her eggs (nits). 

Before School Hygiene came in, findings of over 45 per cent, were 
common amongst girls. Now it has reached less than § per cent, in 
rural, with maximum of less than 5 per cent, in the metropolis. 

And this percentage is for the presence of nits, only very few 
cases of verminous children are seen nowadays. 

Medical inspection, by pointing out this infection and educating 
parents by a descriptive circular, can claim the entire credit of this trans- 
formation, and for a most effective cleaning up. 

DETAILS OF THE NUMBER OF CHILDREN WITH UNSATISFACTORY 

HAIR CONDITIONS, &c. 

Details of the number of children with unsatisfactory hair con* 

ditions will be found in Table VII. The information summarised, is 

as follows : — 

Public, Denominational and Private Schools for 1918 and 1919. 

(a) Metropoltian Area. 

1918. 1919. 

Number of children examined ... 26,893 12,019 

Number with unsatisfactory hair conditions 1,019(3-7%) 446(3.7%). 

Number subsequently freed 840(82-4%) 347(77-8%). 

(b) Large Country Toiuns. 
28,998 



Number of children examined 

Number with unsatisfactory hair conditions... 

Number subsequently freed 



... 555 ( 1-9%) 
447 (80-5%) 

(c) Small Country Towns and Villages. 
,.. 14,112 

115 ( 0-8%) 
102 (88-6%) 



Number of children examined 

Number with unsatisfactory hair conditions... 

Number subsequently freed 

(d) Whole State. 
Number of children examined 
Number with unsatisfactory hair conditions... 
Number subsequently freed 



70,003 
1,689 ( 2-4%) 
1,389 (82-2%) 



27,618 

538 ( 1-9%). 
437 (81-2%). 

16,103 

95 ( .0-6%). 
70 (73-6%). 

55,740 
1,079 ( 1-9%). 
854 (79-1%). 



SCHOOL HYGIENE FOR 1917, 1918, AND 1919. 

The suitability and cleanliness of the surroundings of the child 
at school receive regular detailed attention. Every school building 
visited is reported on. The following particulars show the frequency 
of various types of privy accommodation and of water supply, the 
results of the banning of common mugs (common towels have vanished), 
and finally the adequacy or otherwise of playing space. The high 
proportion of rain water tanks in use, the limitation of water sewage to 
the metropolis, and the steadily diminishing number of common drinking 
vessels stand out. Playground spaces are markedly limited in the 
metropolis, and their absence helps to swell the ranks of delinquents. 

The Medical Officers made an inspection of the school premises 
of. 797 schools during 1917; 713 schools during 1918; and 686 schools 
during 1919. Inter alia, the following particulars were obtained : — 

• Privy Accommodation. 





Number of Schools 
reported on. 


Water Closets. 


Pan Closets. 


Cesspits. 


• 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


Metropolitan 
Large Country 
Small Country 


28 
169 
590 


66 
112 
535 


20 
104 
560 


27 
1 


16 

2 


11 
13 


1 

58 
23 


48 
89 
67 


.9 
62 
73 


2 
110 i 21 

567 468 

... 1 


"29 

487 



15 

Water Supply. 





Number of 












Schools 


Town Supply. 


Rain Water. 


Well Water. 


Rivers, Creeks, &c. 




reported on. 












1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


Metropolitan ... 


28 


66 


20 


28 


54 


20 ... 


12 
















Large Country 


172 


112 


104 


9 


48 


27 


155 


64 


77 


4 




... 


4 




... 


Small Country 


587 


535 


557 


3 


5 


7 


574 


524 


541 


5 


2 


4 


5 


4 


5 



Drinking Vessels. 





Number of Schools 
reported on. 


Number of Schools 
with Drinking Vessels 
for use 
in common by the 
children. 


Number of Schools 

where Drinking Vessels 

for use in common 

by children, 
were not found. 




1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


Metropolitan 

Large Country ... 

Small Country 


28 
172 

582 


66 
112 
535 


20 
104 
557 


3 

54 
256 


6 

14 

153 


9 

78 


25 
118 
326 


60 

98 

382 


20 

95 

479 



Playground Accommodation. 





Number of 

Schools 

reported on. 


Average number 

of children 

Using Playgrounds. 


Total Area of Playground Space provided 


Average Playground 
Area 
per Child. 




1917. 


1918. 1919. 

1 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


1917. 


1918. 


1919. 


Metropolitan 
Large Country 
Small Country 


28 
173 

587 


66 
112 
535 


20 
104 
562 


24,154 
20,1-80 
18,139 


26,193 
26,583 
13,361 


10,893 
26,711 

17,885 


a. r. p. sq.y. 

45- 2 28 254 

488 10 4 

1338 2 23 U 


a. r. p. sq.y. 
151 2 8 29 
276 2 26 4 
1171 2 8 1 


a. r. p. sq.y. 

42 1 2 14} 

224 35 11 J 

1197 3 5 6" 


sq.ft. 
82-3 
1058-7 
3214-6 


sq.ft. 
250-8 
453-3 

3819-5 


sq.ft. 
169-0 
365-6 

2917-2 



schools. 



Towels for use in common by children are prohibited in public 



DEFECTS OF SPEECH, 1919— STUTTERING AND STAMMERING. 



Boys. 



Girls. 



Percentage 

and 

Total. 



Public Schools 
Denominational Schools 
Travelling Hospital... 
All Schools 



•77% 
(193) 

•9% 

(29) 

•3% 

(6) 

•75% 

(228) 



•22% 

(53) 

•33% 

(12) 

•06% 

(1) 

•24% 

(67) 



•5% 
(246) 
•6% 
(41) 
•2% 
(7) 
•5% 
(294) 



16 

Out of 1,071 children, 1-8 per cent, with defective speech, e.g., 
lisping, stuttering, &c, 304 were stutterers or stammerers. The per- 
centage totals show that one in every 200 children was a stutterer or 
stammerer, but three times as many boys than girls were affected, 1 in 
133 boys, and 1 in 400 girls. That the incidence seems much higher in 
town than in the country is shewn by the small proportion met with by 
the Travelling Hospital, one-third of the percentage for the denomi- 
national schools, which are chiefly urban. No special provision is made 
for this defect. 



COMMUNICABLE DISEASES, 1918. 

(By the late Dr. C. Savill Willis.) 

Measles. — During the year 1915, three years previous to the 
period now under review, a severe epidemic of measles swept over a 
large portion of the State. In the course of that year, 29,472 Public 
(State) School children, or 10-7 per cent, of the net enrolment, were 
attacked with the disease. Measles were again prevalent in 1918, 
but not to so great an extent as in 1915. In 1918 there were 16,157 
Public (State) School children, or 5-4 of the net enrolment, attacked 
with measles. During the intervening years, 1916 and 1917, com- 
paratively few State School children suffered from the disease, vide 
Annual Reports for those years. 

The weather conditions during 1918 presented some outstanding 
features. In the first half of the year there was a considerable rainfall, 
whereas the second half was dry and droughty. 

The above data raises the possibilities of (a) measles having a 
periodicity of about three years in this country; (b) the height of the 
curve of incidence being interfered with in 1918 by the prevailing weather 
conditions. Although observations will need to be continued over 
many more years before definite conclusions can be drawn, these possi- 
bilities appear worth mentioning at present. 

OphtJmlmia. — In previous Annual Reports attention has been 
called to the prevalence of Ophthalmia in certain parts of the State 
In the Report for 1915, the following statement appears : — 

"Back country Schools, when a number of cases of Ophthalmia occur, are 
supplied with pamphlets describing the nature, cause, prevention and treatment of 
the disease. In addition, drugs are supplied to carry out the treatment. The 
pamphlets and drugs are given to parents, with instructions only to use the drugs 
in strict accordance with the advice given in the pamphlet. In many cases, the 
Bush Nurses have assisted the parents in carrying out the treatment" 

This method of dealing with Ophthalmia among school children, which 
is still in force, is intended to bridge over the periods elapsing between 
the visits of this Department's Ophthalmic Surgeons. When our treat- 
ment schemes were started, Ophthalmia was affecting the children of 
the back country to a very serious extent, as illustrated by a report from 
a country school teacher. He states " He did not know what the 
children of his' district would have done without the Doctors of the 
Travelling Hospital. He had seen sheep with bad eyes, but had never 
seen anything to equal the children's eyes that year. Every child in 
the township had blight, and the visit of the Travelling Hospital was a 
God-send." 



17 



This Department's methods of dealing with this Ophthalmia 
scourge has proved most successful. This success is illustrated by the 
following table, which shows the great and progressive diminution in 
the effect of Ophthalmia on school attendance :— 



Yoar. 

1915 
1916 
1917 

1918 



Number of Children absent 

from School Attendance on 

account of Ophthalmia. 

2,161 

1,658 
685 
483 



The table only serves to give an idea of the value of this Department's 
educational and treatment schemes in connection with Ophthalmia, 
in lessening interference with school attendance. Reports from 
teachers, parents, and public bodies, show that very many more children 
and even parents have been greatly benefitted. 

No doubt some, at least, of the improvement recorded with 
regard to Ophthalmia is due to discontinuance of the provision of toweis 
for common use in Schools. 

Ringworm and Scabies (Itch). — The statistics show an unsatis- 
factory state of things with regard to these two diseases. It appears 
there has been an almost continuous rise in the incidence of these two 
diseases among Public (State) School children. This will be seen by 
reference to the following table : — 





Diseases. 










Ringworm. 


Scabies. 


Year 

No. of cases 


1914 
1,134 


1915 
1,221 


1916 
1,273 


1917 

1,988 


1918 
2,076 


1914 
128 


1915 
216 


1916 
165 


1917 
184 


1918 
476 



It is known that many persons in the country have been infected with 
Ringworm frcm mice. Therefore, there is reason to believe that the 
increased evidence of Ringworm shown above has been due to the plague 
of mice that has been such a noticeable feature in the country districts 
in recent years. If this is so, the number of cases should show a con- 
siderable falling off in 1919, as present indications point to considerable 
relief from the mice plague. 

Many local centres attribute the increased number of cases of 
Scabies to infection taken there by returned soldiers. Opportunity has 
not occurred to prove or disprove this theory. 

To control communicable diseases it is necessary to have prompt 
notification, especially of the early cases. For this purpose, dependence 
must be placed on the Local Authorities. It has been necessary to point 
out in previous Reports how the Local Authorities fail in this respect. 
Prevention of outbreaks depends on prompt control of the early cases. 
Nothing more can be done than aid in the suppression of an outbreak 
already started. 

Then it is necessary to have knowledge and intelligent action on 
the part of the Teachers as well as on the part of the Medical Officers. 
Steps are being taken to see that the Students now being trained as 
Teachers will be better equipped in this direction. It is not sufficient for 
a Teacher or Medical Officer to know the sources of infection and the. 

14833-3 



18 

possible modes of transmission. He or she must know the relative 
frequency with which the different factors operate. While it is interesting 
to know that Typhoid Fever may be transmitted by water, it is of less 
importance than the knowledge that the disease is very frequently trans- 
mitted by flies, and by the soiled fingers of typhoid carriers and of those 
caring for Typhoid patients. Though Measles may be transmitted by 
persons ill in bed with a rash present, it is more important to know that 
in the majority of instances infection is transmitted in the pre-rash stage, 
when the patient is going about with what appears to be merely a cold 
in the head. 

As pointed out by Godfrey, New York State Department of Health, 
" the determination of the source of infection is sometimes easy, often 
difficult, and frequently impossible; but it is always worth a good hard 
try. The investigation of cases for the purpose of discovering the source 
of infection is perhaps the least understood procedure in the control of 
communicable diseases." He enumerated the most frequent faults in 
investigations. Even given the most careful and expert investigations, 
there are still disturbing factors to be taken into account. Take, for 
example, the often puzzling increase in the intensity of infection, &c. 
Thus it is known that Diphtheria carriers are never absent from a good 
many London Schools, yet no cases of the disease may occur for some 
years; then, for some reason or other the intensity of infection is increased 
above par, and cases of the disease occur. 

A want of appreciation of such facts as the above leads to hopeless 
confusion, inability to stave off the outbreak, and usually ends in a 
confession of failure by school closure. This, interpreted, means " a 
hopeless mess has been made of this job, partly owing to ignorance, 
partly owing to want of appreciation that disease follows certain regular 
rules, so let us draw a curtain over this hopeless confusion by closing 
down." (J. H. Brincker). 

VACCINATION. 

Particulars of school children who have been vaccinated will be 
found in Table VIII. at the end of this Report. In 1918, the vaccination 
histories of 70,003 children were inquired into. Of this number, it was 
found that 13,213, or 18.8 per cent., had been successfully vaccinated; 
2,067, or 2.9 per cent., had been unsuccessfully vaccinated. The percent- 
age number of children (18.8 per cent.) found vaccinated was considerably 
less than the percentage numbers found vaccinated in previous years, 
viz., 31.4 per cent, in 1917, 41.9 per cent, in 1916, 35.6 per cent, in 1915, 
and 35.1 per cent, in 1914. Many persons, includmg school children, 
were vaccinated during the Smallpox Epidemic in 1913. As it is not 
compulsory, the people of this country do not bother about vaccination in 
non-epidemic times. Many of the children who were vaccinated in 1913 
are now leaving school, and their places are being taken by non-vaccinated 
children. 

INFECTIOUS AND CONTAGIOUS DISEASES. 

The usual investigation into the manner in which Infectious 
Diseases interfered with school attendance was carried out during 1919. 
Statistics have been collected and compiled so as to show the number of 



19 



Net enrolment in 

Public Primary 

Schools. 


Number of Children 

attacked with 

infectious diseases. 


Percentage numb« 
attacked to net 
enrolment. 


231,861 


18,923 


8-10 


267,718 


13,017 


4-86 


273,482 


43,711 


15-C0 


282,410 


3] ,547 


11-10 


292,088 


27,532 


942 


298,799 


29 , 709 


9 94 


305,353 


13,603 


6 00 



children absent from school for each particular disease, both as patients 
and contacts, the information being given for the State as a whole and 
separately for the Metropolitan and Parramatta Districts, Newcastle and. 
Maitland districts, Broken Hill district, and other Country districts. 

The records taken deal with Primary Schools only, and they show 
that during 1919 18,085 pupils were absent from school on account of 
infectious diseases. Of this total, 13,603 were patients and 4,482 contacts, 
the average period of absence for patients being 4.7 weeks and for contacts 
4.9. Dealing with patients only and comparing the figures for 1919 with 
those recorded for previous years a very pronounced decrease is revealed, 
as the following comparative table will show : — 



Year, 



1913 
1914 
1915 
1916 
1917 
1918 
1919 

In summarising the result of infectious diseases for, say, the past 
five years, it is shown that during 1915, 1916, 1917, and 1918, severe 
epidemics of either Measles or Mumps were experienced. For instance, 
in 1915, out of a total of 43,711 pupils absent on account of infectious 
diseases, 29,472 were away owing to Measles; in 1916 Mumps was 
responsible for the absence of 10,759 pupils out of a total of 31,547. In 
1917 another epidemic of Mumps was experienced, and affected 10,296 
pupils out of a gross total of 27,532, while in 1918 Measles caused the 
absence of 16,137 out of a total of 29,709 pupils away for all diseases; 
but the Mumps epidemic did not recur in 1918 and 1919. In 1919, 
however, according to the data collected, the epidemic of Measles did not 
recur, consequently the figures for 1919 are much lower than those 
recorded for the four years stated. Another point which has a bearing 
on the reduction is the fact that the schools in the Metropolitan Area 
and many in the Country districts were closed for a period of 12 out of the 
42 school weeks during the height of the Influenza epidemic which 
prevailed during 1919. 

The disease most prevalent during 1919 was Influenza, this 
complaint accounting for nearly one-half of the total absences. It is 
recorded that out of the total of 13,603 patients for all diseases, 6,159 were 
absent for a period of 4.2 weeks each on account of Influenza. Of the 
other communicable diseases affecting children, 1,531 pupils were absent 
an average period of 3.9 weeks owing to Chicken-pox; 1,677 pupils were 
absent 6.7 weeks each because of Whooping Cough; while Diphtheria 
and Croup were responsible for the absence of 810 children for an average 
period of 6.6 weeks as against .3,239, 3,918, and 3,410 respectively in 
1918. The absences on account of Measles and Mumps were compara- 
tively small during 1919, namely, 670 and 448 respectively, the average 
period of absence for Measles being 4,6 weeks and for Mumps 4.3 weeks* 



20 

In the previous year, 1918, however, Measles caused a severe epidemic. 
Out of 29,709 patients and 12,043 contacts absent from all causes, 26,838 
(16,137 patients and 7,701 contacts) were away because of Measles as 
against totals of 4,751 in 1917 and 670 in 1919. It was especially prevalent 
in the Metropolitan Area, 52 per cent. In Newcastle district 3,357 were 
patients, the other country districts relatively escaped with 4,190. 
Scarlet Fever caused 329 pupils to be absent on an average of 7.6 weeks 
(1918, 911); 107 pupils were absent 11.8 weeks each owing to Typhoid 
or Enteric Fever (1918, 294); Ringworm accounted for the absence of 
982 children for an average of 3.9 weeks (1918, 2,091); 420 pupils were 
away 2.5 weeks each because of Scabies (1918, 848); while 450 were 
compelled to remain away from school for an average of 2.6 weeks on 
account of Ophthalmia (1918, 432); 6 children were absent owing to 
Meningitis (1918, 76) ; 6 for Tuberculosis ; while one was away on account 
of Infantile Paralysis. Allowing for the shorter school year owing to 
Influenza closure a definite reduction in epidemic disease occurred with 
the single exception of Ophthalmia, a real increase in which seems to have 
corresponded with the discontinuance of the Travelling Ophthalmic Clinic. 

The net enrolment at Primary Schools during 1919 was 305,353, 
while, as before stated, the number of children absent on account of 
infectious diseases was 18,085. The average period of absence calculated 
on this net enrolment is therefore .28 of a week, that is to say that each 
pupil enrolled was away about 1| days in the year. 

The percentage of children absent on account of infectious diseases 
to the net enrolment was 6 per cent, for the whole State. In the Metro- 
politan and Parramatta districts the percentage was 3.8 ; in the Newcastle 
and Maitland districts 7.3 per cent, were affected; in the Broken Hill 
district the percentage was 9.8, while in the other Country districts 7.4 
per cent, were away on account of infectious diseases. 



WHAT THE TRAVELLING HOSPITAL IS DOING AND HOW? 

L. 0. S. Po'idevin, Medical Officer in charge. 

At first sight the above title as a subect for special consideration 
might appear superfluous. That very little is known, however, of the 
Travelling Hospital, its aims, methods and achievements, becomes to. 
me increasingly obvious from the manifold queries put to me on the 
subject by Teachers, by Inspectors of Schools, by parents of pupils, by 
School Attendance Officers, and by Medical Practitioners — all people 
more or less directly interested and concerned in the work. 

Moreover, the Travelling Hospital, as one of the many-sided 
activities of the Medical Service, is, I venture to think, destined to play 
no unimportant part in our educational system, and since, in doing so, 
it closely, concerns the national welfare, its work should be of interest to. 
all. Further, it is of the nature of the work that the more publicity given 
to it the more are its aims likely to be promoted. 

The Travelling Hospital is essentially a self-contained entity. In 
its operations and influence it, to a large .extent, differs very considerably 
from all other sections of the Medical Service. It has emerged from the 
early days of experiment into a practical institution working along very 
definite and purposeful lines. It aims at improving the physical and 



21 

mental prospects of the school children by removing physical obstacles 
to their normal and proper development as well as preventing their 
occurrence in the future. Summarised, its work falls into the following 
headings : — 

1. Complete Medical Inspection of Schools and School Children, 

comprising : — 

(A) Medical examination of pupils. 

(B) Immediate notification of remediable defects to parents. 

(C) Sanitary inspection of schools and school buildings. 

2. Treatment of the school children with a view to — 

(a) Removal of defects. 

(b) Prevention of their occurrence in the future. 

3. Conducting special research investigations on a statistical basis 

of health problems having direct bearing on education, such 
as : — • 

(a) The relationship between school efficiency (mental 

capacity) and physical defects. 

(b) Defective nutrition, its incidence, causes, and relation- 

ship to school efficiency. 

4. Creatine' new " viewpoints, and standards of health— 

(a) For parents. 

(b) For children. 

(c) For teachers. 

5. Relieving pain and suffering in cases of emergency outside the 

school in places far removed from medical and dental assistance. 

To consider each of these headings briefly in turn — 

1. (A) The Medical Inspection of the pupils of course 
follows the lines laid down for the ordinary Medical Inspection at 
schools as carried out by Departmental Medical Officers, but in 
many respects the examination is very much more comprehensive 
and the notifiable standards more exacting. The examination is 
essentially an individual one, and a complete record is kept of the 
defects of each child examined in addition to that recorded upon the 
cards. Up to June 1st this year 1,111 children have thus been 
examined at the 45 schools visited. 

I. (E) Immediately after the examination all parents are notified 
of the remediable defects found, which the staff of the Travelling Hospital 
is prepared to treat. No pupils are treated until the parents or guardians 
have been duly notified, and have in turn signified in writing their desira 
to have such treatment carried out. All parents are invited to be present. 

(a) to be given detailed information about the notified defects and 

treatment proposed; 

(b) to witness such treatment; 

(e) to be advised with a view to prevention in the future ; and 

(d) to be given the opportunity, if desired, to have examinations of 

a special nature made on their children, and advice tendered 

thereon. 



22 

As far as parents are concerned, therefore, treatment of their 
children is quite optional. That there is no need for compulsion is 
apparently fully demonstrated in the Travelling Hospital experience by 
the fact that over 93 per cent, of those thus " notified" have this year 
received treatment by the Staff. The exact number of children " notified" 
up to 1st June is 1,081, and the number treated by the Staff, 1,006. Of 
the remaining 75 ' ; notified" but not treated by the Staff, many were 
found after notification to be already under local treatment, whilst a 
fair proportion after consultation with the parents were recommended 
to have other surgical treatment beyond the limits of Travelling Hospital 
work. It is a matter well worthy of special remark, and very gratifying, 
it seems to me, that such a strikingly large percentage as that shown 
above should desire treatment, largely of a specialised nature, at the 
hands of absolute strangers to the parents, as are the members of the 
Staff. Without wishing to draw inferences in this connection, I have 
good reason for suspecting -and the suspicion is comforting to the Staff — 
that " bush telegraphy " is still a very live habit. 

1. (C) Follows the ordinary lines of sanitary inspection of schools 
and school buildings, including, of course, special consideration of the 
school structure, ventilation, seating arrangements' and general accom- 
modation of the pupils; investigations into the water supply, lavatory 
facilities, sanitary arrangements, and general school hygiene, with advice 
to the teacher on any of the above matters as required. 

(2) Treatment is carried out in the school building as soon as 
possible after parents have expressed their desire for it. This section 
may be conveniently considered in two phases : — 

(A) Actual Treatment (removal of defects). 

(B) Preventive Treatment (advice, &c). 

(A) Actual Treatment. 

1. Dental Work, of course, takes a very prominent part in the 
treatment. Of the 1,006 children treated this year up to 1st June, no 
fewer than 925 have been in the dental chair, a big proportion of them 
several times over. The general condition of the teeth of school children 
coming under the Travelling Hospital observation, either through ignor- 
ance or inadvertence, or lack of opportunity, is appallingly bad. It is no 
uncommon occurrence to find children at school with ten or more, even up 
to twenty, permanent teeth carious. Obviously it would be impossible 
to treat such extensive cases completely in the time at the Dental Officer's 
disposal. Every effort is made, however, by doing the urgent work to 
render the mouths as healthy as possible under the circumstances, and 
improve to that extent the school efficiency prospects of such pupils. 
The average Dental Treatment this year works out at 3.1 per child. This 
means an average of slightly over three treatments (three separate fillings, 
or two fillings and one extraction, or three extractions, &c.) per child 
treated. The nature of the dental work is worth emphasising here. 
Every endeavour is made to save the teeth of the children, extractions 
only being undertaken when inevitable. As a comparison between the 
number of extractions and conservative treatments it may be stated that 
the latter are represented by 36 per cent, of the work done. That there 



23 

has been gratifying progress made in these respects is evident by a 
comparison with the percentages for the year 1918, which yielded an 
average dental treatment of. 1.6 per child, whilst conservative treatments 
represented only 5.7 per cent, of the total dental work. 

2. Special Eye, Ear, Nose, and Throat Treatment.— -Up to 1st June 
this year 291 pupils have been treated in respect of their eyes (189 for 
eyelid troubles, Blepharitis, Ophthalmia, &c, and 102, after refraction, 
having glasses prescribed). The proportion requiring glasses is about as 
usual, one child in every ten examined. Eyelid troubles encountered 
were much less frequent and of a much milder nature than formerly — -this 
was specially noticeable in places having had a previous Travelling 
Hospital visit. 

In the matter of minor throat defects 268 have been treated, the 
condition in the great majority of cases having been explained and 
demonstrated to parents, and advice appropriate to such cases given. 
In addition, a further 68, more seriously defective, have been temporarily 
treated, and their parents personally advised and " notified " in the usual 
printed form for " throat and nose." No record of the subsequent 
surgical or other treatment of these latter cases is at present available 
to me, although I am aware of several having been surgically treated. 

As regards the ears, the matter of defective hearing takes a 
prominent place. It is a serious obstacle to school progress. Many of" 
the cases encountered are associated with adenoids and their sequelse, 
and nasal obstruction of various kinds, the removal of which offers the 
only hope of improved hearing. A number of others (69 pupils) have had 
defective hearing in varying stages of impairment relieved by the removal 
of cerumen, or foreign bodies of one sort or another — dead insects, bits 
of pencils, grass seeds, wheat grains, &c. — from one or both ears, and 
thus a frequently unrecognised " drag" on their school progress removed. 
Not only is the hearing of every child tested, but the outer ear is also 
examined by reflected light, and the condition of the membrane, &c, 
noted in every case. Many children with no discoverable defect in their 
hearing still show unhealthy external ear conditions — accumulations of 
cerumen, &c. — which can be remedied and made the subject of advice to 
themselves, their parents, and their teachers, with a view to its prevention 
in the future. 

3. General Medical Treatment. — Many general medical defects, 
hindering and retarding the progress of the pupils, are revealed by the 
medical examination. It may be mentioned that 153 children have been 
treated or their parents advised and "notified" for defects in this 
category— Heart, Skin, Scalp, Nutrition, Gastric Disorders, Chest, 
Goitre, &c. Without going into farther details, it may be stated that 
of heart defects 23 previously unrecognised cases, some quite marked, 
have been observed, their parents in all cases made aware of the condition 
and advised thereon, and their respective teachers acquainted with the 
state of the little one's heart. This information is of great importance 
to teachers, who are thus enabled to exercise special care and vigilance 
in their management of such children, both in the class-room and in the 
play-ground. Many of the children, of course, have, been treated for 



21 

several defects. In all, 512 pupils have been treated for defects other 
than dental, and the average number of such treatments works out about 
as usual with the Travelling Hospital, at 1.5 per child. 

(B) Preventative (advice, etc.) — See Page 2 — (2, Treatment). 

Much of the actual treatment, of course, as considered under (A), 
has prevention partly for its object, but since advice given (1) to pupils; 
(2) to parents, (3) to teachers, has been made a specal feature of Travelling 
Hospital work, this aspect deserves consideration on its own account. 
My experience in the work has taught me that if we are to get a full- 
measure of benefit from our labours it is essential that we must not only 
indicate the prevalence and nature of defects and remedy them as far as 
we can, but we must also impress upon the principals concerned how 
these defects can be prevented in the future, the means for their- early 
recognition when they do occur, and the advantages of, and, indeed, the 
necessity for early treatment, economic and hygienic, in such cases. 
Ignorance and inadvertence, as already hinted, are two of the chief 
causes of the widespread character of the defects encountered. The 
Travelling Hospital Staff endeavours to its utmost to dissipate these 
factors. By so doing only can we get at the root of the problem. With 
this in view, every opportunity, for example, is utilised by the Medical 
Officer during the examination, and by the Staff in the subsequent Treat- 
ment, to instruct the children in fundamental principles of physiology 
and hygiene. Sympathetic and kindly management never fails to enlist 
their cordial co-operation in all measures undertaken for their examination, 
treatment, and enlightenment. One usually finds the children — the 
prospective fathers and mothers of the next generation, be it remembered 
— intensely interested, and ready to apply to their own experience any 
advice given. Abundant evidence could be produced of their intelligent 
absorption of such advice, and of their appreciation of what has been 
done for them. 

As regards (2) parents, the field for advice and instruction is a 
very wide one. The general ignorance of parents on elementary health 
matters is found in Travelling Hospital experience to be remarkable. 
Not 1 per cent, of mothers, for example, know how or where to look for 
enlarged or unhealthy tonsils. How easy this is, the Medical Officer 
demonstrates as apportunity arises. It is gratifying to note the 
existence of a very keen desire for enlightenment on these and kindred 
matters. Every opportunity is therefore given to parents during the 
Travelling Hospital visit to every school, not only to seek advice on 
their own initiative regarding the health of their children, but to receive 
also such advice, demonstrations, and instruction as is thought advis- 
able by the Staff. This aspect from the dental viewpoint is very popular. 
I am including, therefore, at this point, some notes on his experience 
by Mr. T. C. Hawkes, the Dental Officer of the Travelling Hospital. 

Some Dental Experiences and a Suggestion. — (T. C. Hawkes, Dental 

Officer). 

In connection with my experience of Travelling Hospital work, 
one thing stands out with great prominence, viz., the problem of the 
6 year old Molar (so named). 



25 

It is a striking fact that 95 or more out of every hundred of the 
children examined show even before the age of 8 years the existence of 
caries in their 6 year old molars to a greater or less extent. Indeed, it 
is a rarity to find a truly non-defective mouth as regards " 6 year olds" 
at the age of eight. At the age of ten all children show 75 per cent. 
or more of their " 6 year olds" decayed if they have not been removed 
or filled by that age. One child of 5 years and 4 months recently came 
before me for dental treatment with two of his " six year olds " extensively 
decayed, and the other two showing early signs of caries. It is not only 
the widespread occurrence of this decay, but also the extensive nature 
of it that is remarkable. All stages of decay are observable from the 
pinhole type to the putrescent. One might divide them into classes 
each with its appropriate treatment, as follows : — 
(a) Early stage, suitable for permanent filling. 



A permanent 
• " Tooth 



@ ^>h\ Consists of/O teeth 

(f) Upper^^^ Qt) before 6 year Mo/a r 
f^\ Jaw rj\ erupts, 



sL %-+Th/s is a PermanentTooth 

J(6) • 



n 



n 



rejfi 




n 



it 



»t 




Lower J aw 

® O^Consists of 10 teeth 

\tU. O before 6 years Molar erupts. 



WATCH THESE TEETH marked 

Keep them scrupulously CLEAN and prevent decay. 
Have decay attended to immediately. 

(6) Secondary stage, unsuitable for permanent filling without 
considerable preparation. 
The mobility of the Travelling Hospital very often does not give 
time enough for both preparation and completion of the work. In such 
cases work of a temporary nature only can be attempted, the object of 
such work being the temporary preservation of the life of the tooth. 
This is carefully explained, personally, to the parents when present, 
as they are in from 75 to 80 per cent, of cases, and in addition written 
advice is, at the time or subsequently, placed in their hands per medium 
of a form specially designed for the purpose. 

(c) Advanced stage, where the tooth is quite beyond repair. 
Such teeth might with advantage to the patient be either extracted 
or left in situ, according to circumstances. Each such tooth presents 
a case for consideration on its own merits. There are, of course, a 



26 

number of factors to be taken into account in advising parents as to 
treatment. In a large number of cases, and for many reasons, utilitarian 
and aesthetic, such, for example, as articulation, mastication, facial 
contour, &c, it is considered advisable that the tooth should remain in 
situ. In other cases in the interests of the adjacent teeth, and especially 
of the child's health, extraction is the only rational remedy. 

(d) Putrescent Stage. 

This, of course, may be associated with small or large decays. 
In some cases the preservation of the tooth is a possibility, though 
usually beyond the limits of Travelling Hospital work. The results 
and the importance of preservation are explained to parents, and (where 
the facilities for such offer), when their promise to have methods of 
preservation carried out is forthcoming, and seems likely of fulfilment, 
temporary preservative treatment is undertaken. In other cases there 
is no alternative but to extract. 

It is clear, therefore, that in Travelling Hospital experience the 
6 year old molar is a very troublesome customer. He is responsible 
for a very great amount of the dental work. done by the Travelling 
Hospital. He comes unrecognised as a permanent tooth by 99 out of 
every hundred mothers. Residing far back in the mouth of the little 
patient, he escapes the spasmodic and generally futile attentions of the 
toothbrush, and when, by chance, he does come under parental obser- 
vation, his decaying .condition is dismissed from serious consideration, 
as he is " only a first tooth." This is all very regrettable from the 
point of view of school hygiene, because one feels sure that in great part 
it is preventable. As previously stated, not 1 per cent, of mothers and 
teachers know that the '_' 6 year old" is a permanent tooth. When 
this is explained, they readily appreciate the importance of its preser- 
vation. Besides, showing parents the condition and position of the 
teeth in the child's mouth, I use a little model, with the teeth in the 
upper and lower jaws in position, made for the purpose of demonstration, 
and I find they seem to grasp things quicker from the model. I find 
the model very useful, too, in demonstrating the causes and results of 
overcrowding, &c, due in school experience chiefly to either too early 
or too late extraction of the temporary teeth. - In this connection, as 
well as in the matter of the " 6 year old," it seems a great pity that so 
much ignorance exists in the matter of the eruption of the teeth. A 
little knowledge on the subject would save a tremendous amount of 
dental trouble, a deal of unnecessary suffering, and much money spent 
now in rectifying what should have been prevented. The mothers I 
meet, I find intensely keen to learn and ever ready to pass on their 
" learning" to their neighbours, so that it is a reasonable expectation, 
therefore, that, as time goes on, much benefit in the matter of Dental 
Hygiene should arise from these demonstrations to parents. No doubt 
some of the older children, too, as patients, pick up a good deal of infor- 
mation, but surely there is no reason why every child before leaving 
school should not know something definite about such an important 
matter as the eruption of the teeth. A little definite knowledge of the 
subject, combined with a thorough appreciation of the importance of 
teeth cleaning, would in the future result in the preventing of an incal- 



27 

culable amount of the dental caries in school children. In the attain- 
ment of this object, I would suggest that a printed card with a 
diagrammatic representation of the " 6 year old mouth" be placed in 
the hands of every school pupil after appropriate explanation by the 
teacher. These cards could be taken home to parents. A little expla- 
natory and instructive pamphlet could be attached to the card, or the 
salient points could be emphasised on the card after the manner, perhaps, 
of the diagram attached : A similar enlarged diagram could advantageously 
be added to the wall decorations in every school. The accuracy of the 
pupils' knowledge on the subject could easily be tested at the medical 
inspection, and corrected or extended as deemed advisable. This seems 
to me to offer the rational and radical solution of this problem. 

(3) The teacher is a very important link in the chain of prevention. 
His or her cordial co-operation is needed for the full fruition of our work. 
Generally speaking, that co-operation is forthcoming, if not from the 

commencement, at least some time before the close of our visit. It is 
no uncommon experience for the staff to meet at the outset with an 
almost irritating indifference on the part of the teacher, which, however, 
usually rapidly gives way to interest, developing into warm enthusiasm 
when the objects of our work are made clear. During the examination 
the consideration with the teacher of the mental capacity (school effi- 
ciency) of each individual pupil quickens his interest in their individual 
capacity, and the results of the examination often clears away his doubts 
and illuminate his perplexities in regard to the causation of his pupils' 
lack of progress. The teacher is invited to see precisely what is being 
done for each of his pupils, and how it is done. It has been my aim to 
try to get teachers so interested that they often come to feel themselves 
to be for the time being almost a working part of our staff, and the 
intelligent interest displayed by some teachers, and the assistance thereby 
rendered to the staff, greatly facilitates and broadens the work. In 
cases where parents of patients are not present, the teacher is made the 
repository of advice tendered to the little patients, both during and after 
treatment. Teachers have different methods of dealing with this 
matter. Some make notes of their own in reference to different pupils, 
and on general hints that appear likely to them to be useful; others 
provide a book in which the children themselves, who are did enough, 
write down the advice that is given them before leaving the treatment 
room. Thus the teacher not only gets ideas on simple health matters 
as subjects of class study, but also gets to understand his pupils better, 
besides being brought into close touch with their parents on common 
ground in a way that is likely to be as mutually beneficial as it is new 
to many teachers. Not wishing to labour this aspect of Travelling 
Hospital work, I think I have written enough to indicate how wide is 
the field, and how hopeful is the harvest to be cultivated in the future 
from these little hygiene seeds by teachers, pupils, and their parents. 

All this, of course, could not be possible without a loyal and 
enthusiastic staff. I would like to pause here, therefore, to place on 
record my appreciation of the cheerful enthusiasm, the patient endeavour, 
the genuine industry, and the loyal co-operation of my fellow workers 
' on the staff. One of the busiest members of the party is Nurse Fraser, 



28 

whose work is of the utilitarian nature not reducible to figures, as exacting 
as it is unobtrusive — now doing clerical work, the next moment dis- 
pensing sympathy and encouragement to a nervous dental patient, or 
preparing a dental rilling, and all the time attending to the many and 
varied requirements of the Dental and Medical Officers, and in particular 
to the sterilization of instruments. As a tribute to the sterilization, 
I may remark that, despite the septic field of operation for much of 
the dental work, not a single instance of after trouble — such as might 
reasonably be expected occasionally — has been brought to my notice. 

3. (See page 21.) Very brief reference will be given here to this 
heading, as the various subjects concerned deserve, and will receive, 
separate and special consideration. As regards (a), statistical evidence 
is rapidly accumulating in proof of the very direct relationship between 
school efficiency and physical defects. There would appear to be in 
Travelling Hospital experience a fairly constant percentage of gross 
retardation as expressed in terms of mental capacity, as backward or 
dull or feeble-minded. This proportion of gross retardation usually 
exceeds 30 per cent, of the pupils examined. Of these about 95 per cent, 
show the existence of gross physical defects, such as are certain to greatly 
hamper school progress. If we put the matter another way, it can be 
shown that by taking only the children exhibiting such gross defects, 
the percentage of backwardness and dullness runs up to about 60 per cent. 

Referring briefly to (b) there can be small doubt either as to the 
very definite relationship between defective nutrition and sclwol efficiency 
Recent statistics give about 30 per cent, of those examined as being 
below the normal in the matter of nutrition. This seemi very high for 
country children, and possibly the prolonged drought has not been 
without its influence. As might be expected amongst these children 
showing defective nutrition, the proportion below their school efficiency 
is very high — over 60 per cent., in fact. The various causes of ill- 
nourishment are being carefully investigated (and, where possible, 
rectified during the Travelling Hospital visit), with the hope in the near 
future of eliminating much of this " drag" on school progress. Travel, 
ling Hospital work offers an unique opportunity for investigating these 
and kindred matters ; the opportunity is being availed of, and the 
results will be set forth as soon as the field of statistical consideration 
warrants the establishment of definite conclusions. 

4. Creating New " Viewpoints " and Standards of Health. 

(a) For Parents (see page 21). — The presence of parents during the 
Travelling Hospital visit to every school, and the routine in connection 
therewith, followed by the Staff as previously outlined, leads naturally 
in most cases to an amended view of parental obligations. For example, 
parents get to realise, what perhaps has never occurred to them before, 
that the care of their little ones' teeth up to a certain age is a direct 
responsibility, and that the old method of trusting that the teeth are 
alright unless the children complain of toothache is faulty, expensive, 
and decidedly unfair to the children. From what they see, we hope that 
they will gather the impression that it is not " a tragedy to put the little 
ones in a dental chair," nor is it an impossible but rather a very simple 
task for them to have a look at their children's throats. When able to 



29 

see throat conditions for themselves, they more readily learn to appreciate 
that if allowed to become chronic they are frequently fraught with serious 
and lifelong disabilities to the individual. 

Again, a little explanation usually easily breaks through the 
barriers of foolish " objection to spectacles," behind which many parents 
are wont to shelter, and when they see for themselves that it is not an 
intolerable ordeal to have defective eyesight tested by refraction and 
correcting glasses prescribed, the need for wearing thim is seldom neglected. 
As a result of this, and in other ways, they come to fully realise that the 
many minor physical ailments, some of which they are aware of, others 
they hear about for the first time as a result of the medical examination, 
very often seriously hamper their children's education at school, as well 
as in after years sadly interfering with their prospects in life. 

(b) For Children. — Much of what has been previously written 
applies here. The children are taught not to fear either the Doctor or the 
Dentist. First impressions go far with children. They experience the 
benefit of treatments, and it is the usual thing to find them when 
circumstances permit willingly and cheerfully returning again and again 
to the dentist for more and more treatment. The sense of appreciation 
thus aroused must bear fruit in the generations to come. 

(c) For Teachers. — Obviously the teacher is a most important link 
in the chain of benefit to be derived from the Travelling Hospital visit. 
Most teachers recognise that they can do a great deal in the furtherance 
of the work thus commenced. As a result, in many cases, they understand 
better their pupils, and what might reasonably be expected of them. The 
examinations' findings, with hints on hygiene dropped by the way, the 
treatment of defects with its attendant explanations, the observation of 
results, all tend to give the alert teacher a closer personal interest in the 
physical and mental development, as well as the individual capacity, of 
every member of his school. Enough has been written under previous 
paragraphs to more than establish the importance of this essential factor 
in the sum of success. 

5. Relief of Pain and Suffering in Cases of Emergency other than 
School Pupils (see page 1). 
This is a matter calling for tact and the exercise of discretion by 
the Staff. While never turning our backs on genuine suffering, we have 
to strenuously refuse to be " made a convenience of," as would be the 
case were we to yield to half the applications for treatment. As no 
charge is made and no fee accepted by the Staff for this work, miiiy 
appear to think the chance of getting medical advice or dental treatment 
for nothing too good to be missed. It has been made the rule to treat 
only very urgent cases or cases of emergency and real suffering, except in 
places very far removed from medical and dental assistance, when the 
rule is somewhat relaxed according to discretion. For the period covered 
by this report 58 such cases have been treated without fee or reward of 
any kind, except the satisfaction of having done a kindly act. The 
majority of these cases have been dental. I have never known the 
Dental Officer, no matter how late the hour at night, nor how inconvenient 
the circumstances, refuse treatment to a sufferer from toothache. Since 
1918 over 250 " outside cases" have been treated by the Staff, including 
amongst a great variety of cases, one confinement, several fractures, and 



30 

numerous eye cases requiring specialist treatment. This represents a 
large amount of extra work done by the Staff, a considerable amount of 
responsibility undertaken, and a certain amount of departmental material 
used free of all cost. It is the customary thing for our patients after 
treatment to offer the current fee for such work, and when this is refused, 
as it always is, by the Staff, though some are obviously pleased, the great 
majority would prefer to express their gratitude in the shape of a fee. 
I would suggest, therefore, as some compensation to the Staff, and to 
provide a means for grateful patients to effectively discharge their 
obligations, that a means be devised and approved so that such fees 
could be accepted through the Department as a donation to some approved 
charity, to be distinctly marked as having been realised through the 
efforts of the Travelling Hospital. 

Though I have exhausted the headings which I set out to consider, 
and given, I trust, a faithful account of the Travelling Hospital work, 
there is still one little matter that really deserves mention. It must be 
remembered by the reader, for instance, that the work has to be carried 
through under all sorts of disadvantageous conditions, in unsuitable 
rooms, hampered by bad light, &c, &c. It not infrequently happens 
that dental work, owing to badly lighted interiors, has to be carried out 
in an unsuitable porch or lobby — the best of a bad lot — whilst sometimes 
the difficulty in making a satisfactory dark room for eye work is almost 
insurmountable. There is also an enormous amount of packing and 
unpacking of the whole dental and general outfit, and sterilisation and 
resterilisation before use. Sometimes this has to be done at two schools 
in the one day. It has been done considerably over 100 times during the 
fast half-year. On several occasions the water for sterilisation of instru- 
ments has to be carried, in kerosene tins, in the car to schools sometimes 
over 20 or 30 miles, whilst the difficulty in getting towels, &c, washed, in 
many places, is a source of much worry to our Nurse. Finally, the travel 
must not be forgotten. It is quite a regular thing for the Staff to travel 
40, 50, or even 60 miles or more in the car during the day, and do a day's 
work in school as well. On two different occasions, though not recently, 
the average daily car travel for a whole week of seven days in each case 
was over 90 miles daily, whilst in one case five schools were treated, and in 
the other six. Only for one week during the period covered by this 
report has the Staff averaged over 50 miles daily. The total mileage 
Covered in the car by the Staff for the above period, half-year up to 1st 
June, has been 2,453 miles, and as travel took place on 67 days, this gives a 
daily average for such days of 36.6 miles. In addition, a further 94 miles 
have been travelled by rail. The Travelling Hospital does not belie its name. 

In conclusion, may I " top up " with a little of the "froth" of our 
experience ? Many requests, for instance, reach me by letter from 
parents in regard to the proposed treatment of their children. Some of 
them make strange reading, but the following is one of the most com- 
prehensive : — " Please repair my child where necessary." The card 
sent home to parents bearing questions to be answered in relation to the 
child's previous health-history return laden with much unconscious 
humour. Two specimens the reader may find difficulty in 
deciphering are " Arricyppellars" and " Direar." 'When and for 
what ailment was the child last seen by a doctor ? " has resulted, 



31 

amongst others, in the following replies : " No. 1911 with information 
of throat and toncils"; "broken harm"; "aneroids in the ears"; 
" A sist"; " with catara stummick"; " delicate from berth," upper 
or lower not stated. It must be admitted that the unfortunate 
mentioned below had a very narrow escape. In reply to the question 
" What other injuries or illnesses has the child had, and when ? " it was 
stated that the child " fell on brass clasp of corsets at 9 months old and 
nearly died of information in the head." 

REPORT OF THE SCHOOL NURSES. 

(Nurses Haslam, Scott, and Gillespie.) 

The work of the School Nurses has been greatly interfered with 
by the influenza epidemic of 1919. Visiting with regard not only to 
schools in 1919, but also of the 1918 series, was affected. 

In the 1918 schools, the part of the work which was carried over 
to 1919 could not be completed for the parents who were visited would 
not visit hospitals. The advice published in the newspapers produced 
a general fear of crowds, and the hospital outpatient departments were 
avoided, and indeed eventually closed. 

When the schools re-opened it was found that a large percentage 
of ehildren had left school, or had gone to other schools, so that it was 
impossible to get any information regarding them, or of the result of 
the visits paid to the parents previously. 

Of the 1919 schools one, Crow's Nest, medically inspected early 
in January, was so disorganised on account of being used as a Influenza 
Hospital that a large number of children could not be traced, as some 
had left and gone to other schools, or left school altogether when the 
work was resumed on 5th August, 1919. 

Between February and August, 1919, Nurses Fraser, Gillespie, 
and Scott worked for various periods at depots, influenza hospitals, and 
at the Head Office (inoculations ; and Nurse Haslam assisted with 
inoculations at Head Office, and then relieved for two months with the 
Travelling Hospital, while Nurse Fraser was absent on sick leave. 

Then in 1920 Nurse Gillespie was away in the country from 14th 
January, for two months, relieving with a Travelling Dental Clinic while 
the Nurse was on sick leave. 

The Work for 1918. — The time actually taken up in visiting parents 
extended from 7th May, 1918, to 28th January, 1919, a total of 31 weeks 
instead of the usual year of 47 weeks. In this time the parents of 
7,151 children were visited; out of 11,470 notified, 6,736 were treated, 
and of these 2,972 were treated as result of Nurses' visits, 3,764 having 
responded to the ordinary notices. Thus 33 per cent, responded readily 
and the Nurses' efforts raised this to 58 per cent. — 41 per cent, of those 
visited responding to the visit of the nurses. 

The Work for 1919 extended from 5th August, 1919, to 12th May, 
1920, a total of 31 weeks for each nurse, including 3 weeks special clerical 
work in the Head Office. 

In this time the parents of 4,277 children were visited out of 
6,501 notified, and 4,495 were treated; of these 2,588 were treated as 
result of Nurses' visits. The first response was thus 30 per cent., raised 
by the Nurses' visits to 70 per cent,, response being obtained by them 
to 60 per cent, of their visits. 



32 

In comparison with the results for 1917 schools, when :— 
14,206 children were notified, 
8,229 children (total No. treated), 3,557 of these being treated as 

result of Nurses' visit, 
9,376 children whose parents were visited, 
33 per cent, responded to the Departmental notice, and the Nurses' efforts 
raised this to 58 per cent., representing 38 per cent, response to the 
Nurses' visit. The percentage of treatment is thus higher as a result of 
Nurses' visits for 1919, although not so many visits were made on 
account of fewer children being medically inspected, and the influenza 
epidemic. 

The difficulties coped with are very great. The people the Nurses 
deal with live so closely together that should one go to consult a doctor 
or dentist regarding defects notified, and be told that nothing is wrong, 
probably a whole street will refuse to have treatment. 

Parents also have the impression, passed on from one to another> 
that operations for adenoids, or enlarged tonsils, will have to be done 
repeatedly, with no improvement. The large majority of parents were 
entirely ignorant of how the teeth erupt, and it is very hard to convince 
them that the molars which come between 5 and 6 years of age are 
permanent. 

As a result of the Nurses' visits year after year, a marked improve- 
ment has taken place, although this idea has still to be explained to a. 
great many. 

Treatment is often refused by people on the ground that " they 
never had these various defects when they were children, and the children 
can wait until they are old enough to get their own treatment." 

Then in Eye and Ear defects the parents will not have them 
" tampered" with, and again the Nurses frequently take children to 
hospital for the parents, and then have the parents refuse to use the 
Atropine drops, prescribed for home application preparatory to refraction. 
So the work is wasted, and the children remain without treatment. 

Then parents consult the children in many cases as regards their 
wishes, and will tell the Nurses' without any reserve, that the children 
refuse to wear glasses or to have their teeth or tonsils treated, and this 
decision is final. The worst case of all is when a parent is visited, who 
will simply not discuss the matter of notification at all, but says that he 
will not have anything done, and has his own doctor, and does not wish 
for the Education Department's interference. 

Occasionally parents will not go for treatment until they can 
provide suitable clothes — if possible, help is given by the Nurses. In 
some very poor cases railway fares to Clinic or Hospital cannot be pro- 
vided by parents, so the child cannot be treated. 

Appointments are made for parents who wish to take their children 
to the Dental Clinic. This makes things easier for them, especially in 
cases when some reason exists that the parents or guardians cannot 
personally go with their children, the Nurse takes the children herself. 

Cases are sometimes brought under the Nurses' attention of 
State children not receiving proper care from their guardians; for 



33 

instance, a child at R Public School, whom the Teachers were 

supplying with sufficient lunch. Any instances are reported to the 
State Childrens' Relief Headquarters for action. 

Special cases of neglect are occasionally met with : — In a case at 

L the parents were away all day, and the child stayed at home 

to mind two children, and nothing was left for them to eat until evening. 
This was reported. Treatment for ear defect was obtained, and the 
child's attendance at school and personal cleanliness was greatly 
improved. 

The Nurses have found, in the short time that children have been 
permitted to obtain treatment at the Metropolitan Dental Clinic, upon 
the direct authority of the Principal Medical Officer, that a great need 
has been supplied by this concession, and the way smoothed for treat- 
ment for the children notified in the same family. 

CONCLUSION OF MEDICAL REPORT. 

The period 1918-19 saw the completion of the second round of 
medical inspection, during which practically every public and most 
private schools were visited twice, and over 430,000 individual examina- 
tions made. 

Of these, 60 per cent, were notified for various defects, and of 
those notified 126,000 were treated (46 per cent.) 

During the second round treatment improved, as compared to the 
first round, from 40 per cent, to 53 per cent. 

At least 100,000 in addition were treated as the result of inspec- 
tion by outside agencies, representing a total of over 200,000 children 
benefited. 

The administrative difficulties have been great. The great dis- 
tances and enormous areas to be covered influenced type of work as 
well as cost, and rendered it difficult to obtain and keep suitable medical 
officers. Scarcely had the present scheme begun when war came on the 
scene and accentuated every difficulty — supply of officers, cost of 
material, financial votes, &c. 

In spite of all this, progress has been maintained, and New South 
"Wales still holds first place in Australia for the completeness of the 
school attack and the development of treatment. 

Yet, rightly considered, only the skeleton framework has been 
laid down, to be filled up with preventive and curative progress. In 
hygiene the unit of education is the teacher, and his services remain 
untouched. Yet in the control of epidemics, of sanitation in general, 
the supporting of the work both of inspection and treatment, the teacher 
is the chief agent, and he or she alone can do it effectively. 

Not only must the services of the teacher be utilised as an agent 
in school medical work on its administrative aspects, but also more 
directly in the training of the child to a full realisation of health and 
health habits. 

As an appendix to this report will be found the Statistical Report 
(Mr. Mecham), with a most valuable collation of figures for height and 
weight for 1914-15-16. It is, I believe, the largest yet attempted in any 
Australian State. Considerations of Australianship and of town and 
country location are the lines illustrated in the anthropometric analysis. 
14833— C 



34 



Table I.— DETAILS OF MEDICAL INSPECTION -1918. 





s /Boys... 
\ Girls... 




A.— Public 


Schools. 


j 


B. — Denominational and Private Schools. 




Metro- 
politan. 


Large 
Country. 


Small 
Country. 


Wand 

Total 

all 

Districts. 


Metro- 
politan. 


Larae 
Country. 


Small 
Country. 


(Jrand 

Total 

ail 

D strie's 


• 


Dr. Bevan. 

Dr. Eieisten 
Dr. Stewart. 
Dr. Malone. 
Dr. JJewn- 
hatn Davis. 


Dr. Coghlan. 
Dr. \ aic. 
Dr. Quessy. 
Dr. Thomson 
Dr. Malone. 
Dr. Maokay. 


Dr. Quessy. 
Dr.TajuijOn 
Dr. Malone. 
Dr. Mackay. 
Dr. >iewn- 

ham D ivis. 
Travelling 
Hospital. 


Total. 


Dr. Bevan. ! 
Dr. JSJelstenj 
Dr. Stewart. 
Dr. Malone. ! 

' 1 
j 


Dr. Coghlan. 
D.-. \ aie. 
Dr. Quessy. 
Dr. Thomson 


Dr. Quessy. 
Dr.Thoinson 
Dr. Malone. 
Dr. Mackay. 
Dr. Newn-" | 
him Davis. j 
Travelling 
Hospital. 


Total. 


Number of Pupils enrolled at School 
examined 


14,194 
13,790 


14,200 
13,467 


G,2S5 
8,203 


37,079 
35,471 


1,800 
1,948 


2,229 
3^090 


1,624 
1,559 


5,659 
0,597 


Total 


27,990 


27,007 


17,493 


73,150 


3,754 


5,319 


3,183 


12 256 




./Boys... 
\GLls... 






12,516-1 
12,061-5 


12,382-6 
11,532-9 


7,919-9 132,818-0 
0,923-9 ; 30,518-3 


. 1,607-5 
1,673-5 


1,944-1 
2,705-1 

4,649-2 


1,411-8 
1,310-1 


4,903-4 

5,088-7 


Total 


24,577-6 


23,915-5 


14,843-S 


03,330-9 


3,281 


2,721-9 


10,052-1 




. f Boys... 
\ Girls... 




12,030 
11,400 


12,719 
11,775 


8,223 

7 e >*»9 


33,578 
30,407 


1,436 
1,427 


1,899 

2,005 


1,365 
1,275 


4,700 
5,307 


Total 


24,030 


24,494 


15,521 


64,045 


2,S63 


4,504 


2,040 


10,007 




./Boys... 
\ Girls... 




7,920 
7,280 


8,280 
7,923 


4,935 
4,523 


21,147 
19,726 


923 
961 


1,135 

1,029 


871 

858 


2,929 
3,448 


Total 


15,206 

1,071 

109 

91 


10,209 

1,043 
377 
138 


9,458 

790 
377 
188 


40,873 

2,904 

863 
417 


1,884 

152 
15 

7 


2,764 

183 

53 
32 


1,729 

219 
61 

28 


0,377 

554 


Eyes- 




129 


Other defects 


67 








Total 


1,271 


1,558 


1,355 


4,184 


174 


208 


SOS 


750 








Ears — Hearing — 


724 


1,000 


410 


2,134 


60 


190 


91 


347 


Slight 










Total, Hearing.... 


724 


1,000 


410 


2,134 


66 


190 


91 


347 










114 


100 


42 


256 


17 


7 


14 


38 








Total 


838 


1,100 


452 


2,390 


83 


197 


105 


385 








Nose and Throat- 
Tonsils 


1,714 

509 

230 

23 

19 


2,216 

1,237 

1,511 

38 

37 


1,649 

359 

550 

25 

46 


5,579 

2,105 

2,297 

91 

102 


195 

24 

29 

5 

1 


376 

187 
112 

5 
6 


256 
63 

so 

8 
8 


8 9 7 


Tonsils and Adenoids 


274 




231 


Disease of Nose 


18 




15 








Total 


2,500 


5,039 


2,629 


10,174 


254 


686 


425 


1,365 


Dental — 




Second Teeth — 


1,381 
9,733 


2,277 
9,665 


1,090 
5,320 


4,754 
24,718 


204 
1,256 


324 
1,675 


233 

1,034 


761 


Slight 


3,965 






Total 


11,114 


11,942 


6,416 


29,472 


1,460 


1,999 


1,267 


4,726 








Gross First Teeth only 


2,304 


1,648 


1,123 


5,140 


223 


259 


141 


623 








Deformities- 
Shoulders, Round 


28 

1 

1 


189 

1 


234 

1 

2 


451 

1 
1 

2 

2 




23 
1 

2 
2 


43 


66 


Curvature — 

Post 






1 


Limbs — 






2 




2 








Total 


30 


190 


237 


457 




28 


43 


71 








Skin 


106 

3 

3,172 

1 

198 

421 

33 


332 
16 

2,823 

10 

484 

504 

178 

2 


84 

8 

1,995 

21 

690 

333 

63 

6 


522 

27 

7,990 

32 

1,372 

1,258 

274 

8 



294 

"26 

57 
3 


82 

422 
2 

83 

90 

68 

1 


16 

1 

373 

6 

99 

43 

14 

4 


104 




1 




1,089 




8 




208 


Defective Speech 


190 




85 




5 








Total defects 


22,057 


25,826 


15,417 


63,300 


2,580 


4,185 


2,845 


9,610 







Inis table does noo laciude tne aoornrinai suiiuuis examined. 
NOTE.— The eye, ear, nose, and throat, dental and skin defects, and hernia shown in detail are such as are sufficiently serious to need treatment. The other 

defects shown include conditio- . i.My serious to notify parents. 



35 



T 


ABLE I.— DETAILS 


OF MEDICAL INSPECTION— 1919. 








ools/Boys... 
,. \ Girls. . . 


A. — Public Schools. 


B. — Private Schools. 




Metro- 
politan. 


Large 
Country. 


Small 
Country. 


Grand 

Total 

all 

Districts. 


Metro- 
politan. 


Large 
Country. 


Small 
Country. 


Grand 

Total 

all 

I istricts 




Dr. Bevan. 
Dr. Edelsten 
Dr. Malone. 
Dr. Thomson 


Dr. Coghlan. 
Dr. Dillon. 
Dr. Vale. 
Dr. Malone. 
Br. Mackay. 
Dr. Quessy. 
Dr. Thomson 


Dr. Malone. 
Dr. Mackay 
Dr. Quessy. 
Dr. Thomson 
Travelling 
Hospital. 


Total. 


Dr. Bevan. 
Dr. Edelsten 
Dr. Malone. 
Dr. Thomson 


Dr. Coghlan. 
Dr. Dillon. 
Br. Vale. 
Dr. Malone. 
Dr. Mackay. 
Dr. Thomson 


Dr. Malone. 
Dr. Mackay. 
Dr. Quessy. 
Dr. Thomson 
Travelling 
Hospital. 


Total. 


Number of Pupils enrolled at sell 
examined 


6,715 
6,091 


13,607 

13,438 


10,769 
9,960 


31,091 

29,489 


1,262 
1,121 


2,132 

2,603 


1,050 

1,047 


4,444 
4,771 


Total 


12,806 


27,045 


20,729 


60,580 


2,383 


4,735 


2,097 


9 215 




\ Girls... 

\ Girls ... 






5,454- 1 
4,925-7 


11,686-9 
11,262-9 


9,060-1 
8,259-1 


26,201-1 

24,447-7 


1,092-2 
942-1 


1,779-1 
2,174 


905-8 
890-3 


3,777-1 

4,012-4 




10,379-8 


22,949-8 


17,319-2 


50,648-8 


2,034-3 


3,953-1 


1,802-1 


7,789-5 




5,534 
4,897 


12,153 
11,623 


9,266 
8,436 


26,953 
24,956 


822 
766 


1,753 
2,089 


856 
899 


3,431 
3,754 


Total 


10,431 


23,776 


17,702 


51,909 


1,588 


3,842 


1,755 


7,185 




\ Girls... 


Number notified as defective .... 


3,583 
3,077 


8,010 

7,640 


6,246 
5,596 


17,839 
16,313 


484 
490 


1,060 
1,326 


541 
575 


2,085 
2,391 


Total 


6,660 


15,650 


11,842 


34,152 


974 


2,386 


1,116 


4,476 






Eyes- 


401 
36 
53 


1,067 
588 
117 


743 

890 
172 


2,211 

1,514 

342 


104 
3 

39 


191 
83 
33 


88 
44 
22 


383 




130 




94 








Total 


490 


1,772 


1,805 


4,067 


146 


307 


154 


607 








Ears— Hearing — 


. 319 


816 


320 


1,455 


59 


175 


47 


28l' 


Slight 










Total, Hearing. 


319 


816 


320 


1,455 


59 


175 


47 


281 










52 


123 


94 


269 





22 


4 


32 








Total 


371 


939 


414 


1,724 


65 


197 


51 


313 


Nose and Throat- 




678 
81 

111 
3 
1 


2,202 

1,158 

848 

47 

19 


1,172 

565 

1,357 

64 

77 


4,052 

1,804 

2,316 

114 

97 


95 

17 

20 

1 


343 

174 

148 

5 

5 


168 

67 

74 

3 

14 


606 




258 




242 




9 




19 








Total 


874 


4,274 


3,235 


8,383 


133 


675 


326 


1,134 


Dental- 
Second Teeth — 




550 
4,301 

4,851 


1,834 
9,660 


1,444 
7,342 


3,828 
21,303 


62 
658 


281 
1,415 


127 
660 


470 


Slight 


2,739 








Total 


11,494 


8,786 


25,131 


720 


1,696 


793 


3,209 










1,130 


1,608 


1,430 


4,168 


110 


252 


151 


513 








Deformities — 


43 


101 


308 


452 


32 


34 


22 


8S 


Curvature — 

Post 








Limbs — 


















Total 


43 


101 


308 


452 


32 


34 


22 


88 








Skin 


55 

1 

1,412 

2 

25 

183 

36 


361 

3 

2,994 

13 

356 

450 

172 


100 

2,391 

10 

518 

299 

183 

11 


516 

4 

6,797 

25 

899 

932 

391 

11 


12 

1 

211 

21 
34 

o 


43 

353 

55 
71 
36 


3 

233 

" - 54 

34 

9 


58 




1 




797 








130 




139 




47 












Total defects . 


9,473 


24,537 


19,490 


53,500 


1,487 


3,719 


1,830 


7,036 







Note.— The eye, ear, nose, and throat, dental and skin defects, and hernia shown in detail are such as were sufficiently serious to need treatment, The other 

defects shoyra include conditions not sufficiently serious to notify parents. 



36 



Total number treated 
all action 
(from returns to hand). 


o 


T3 

5 


o 


Number treated 

as a result of further action. 

(" following up"). 

- 


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-+- cs-^-^eo -n 






CO CO pH CO CO O 01 



o tc 

f 



■S-5J3 

:— -^ ■« 



8 HH<<fiO 



Og 



1 s 8.2 1 



Eh 






lot 



•2 S£ 



4 



'111 I 



44 



"8 

s 
s 



H 
55 

«! 

H 
P3 

DD 

H 
O 

m 
m 

o 

|3 
1 

m 



o 

w 

o 



is 

!> 

<! 
« 






•sjooqog TIV 

•BIB,OX 



•sjoonug 

^■EVUJ pUB 

IBnoiiBumiou^Q 



•siooipg ouqnd 



CD 




T* 


© 


ift 






CO 


iQ 




00 




<N 




ia 


CO 







CO 




Irt 


© 


CS 




.-I 


^? 


1-1 






o 


r- 


CO 


cs 


t-< 




<M 


r-i 





tea 2 



•S[ooqog ny 
•siu^ox 



BaonB uuion q 



•Sjooi^gonqn^ 



58 — " J 
S a^ 



•siooipy 

aqBAU^ puB 

prjonBuuuou. a 



00 ^H CO rH CO 



ea go 

COCO 
CO CM 



<N cm wno 



OS 



: 3o 






<-<flo 



I |2~ 
I Bob 

a, 0h 



°5 S M a B 
t.Q<i>3cnH 



5 

-a 9 



.gs-s 



45 



Table V.— SHOWING THE NUMBER OF SCHOOLS AT WHICH MEDICAL 
INSPECTIONS WERE CONDUCTED, 1918-19. 





1918. 


1919. 




Departmental 

Schools. 

Number examined. 


Denominational 
and Private 
Schools. 
Number examined. 


Departmental 

Schools. 

Number examined. 


Denominational 
and Private 

Schools. 
Number examined. 


Metropolitan 


66 
112 
426 
136* 


23 
45 
37 
15* 


20 
107 
487 

96* 


15 




36 


Small Country towns and villages 
Travelling Hospitals 


26 
4* 








740 


120 


710 


81 



* The Departmental officers also treated the children at these schools. 

Table VI— PARTICULARS OF MEDICAL EXAMINATION FOR ADMISSION TO THE TEACHING 

SERVICE AND TRAINING COLLEGE, 1918. 

(a) General Details. 







Examine* 


. 


Passed. 


Deferred for treatment, 
but subsequently admitted. 


Rejects 


as Physically 
Unfit. 




Males. 


Females 


Total. 


Males. 


Females. 


Total. 


Males. 


Females. 


Total. 


Males. 


Females. 


Total. 


Candidates for Admission to Service direct ... 
Candidates for Admission to College (long 
course) 


16 
48 
58 


29 
119 
286 


45 
167 
344 


8 
21 

28 


16 

68 
128 


24 

89 

156 


5 
21 
28 


12 

48 

151 


17 

69 

179 


3 
6 
2 


1 
3 

7 


4 
9 


Candidates for Admission to College (short 
course) 


3 








122 


434 


556 


57 


212 


269 


54 


211 


. 265 


11 


11 


22 



(6) Defects for which Candidates were Deferred. 



Number 
Deferred. 


Teeth. 


Teeth 
and 
Albu- 
minuria. 


Teeth 

and 

Vision. 


Teeth 

and 

Dysmem- 

orrhoea. 


Teeth 
and 
Skin. 


Teeth 

and 

General 

Health. 


Teeth 
and 
Thyroid 
Enlarge- 
ment. 


Teeth 

and 

Tonsils. 


Teeth 
Adenoids 

and 
Hearing. 


Vision. 


Vision 

and 
Chest. 


00 

CD 

"3 


0> 

"3 
S 

CD 

fa 


CS 

-*> 


H 


cu 

13 

a 


"3 

a 

CD 
fa 


"3 



■3 
a 


OT 

CD 

"3 

a 

<D 
fa 


*3 

H 


"3 




a 

a 


3 


H 


CD 

"3 
3 


a 

CD 
fa 


0* 
H 


§ a "3 

S | fa H 


CD 

"3 


1> 

a 
fa 


C8 

O 

H 


CD 

"3 

a 


CD 
<S 

a 

CD 

fa 


CO 
O 

H 


"5 

a 


a 

fa 


CO 
O 

H 


cu 

3 

i 


CD 

CO 

a 
fa 


cO 
O 

H 




CO 

8 




CO 

a 
fa 


CO 
+^< 

O 

H 


"3 

a 


s 

CO 
fa 


5 


H 


54 


211 


265 


39 


151 


190 


3 





3 


1 


5 


6 




6 


6 




1 


1 




1 


1 




1 


1 




1 


1 




1 


1 


2 


15 


L7 




1 


1 


Vision 

and 

Hearing 


Tonsls. 


Adenoids. 


Laryn- 
gitis. 


Heart. 


Hearing. 


Albu- 
minuria. 


Menstrual 
Disturb- 
ance. 


Goitre. 


General 
Health. 


Fainting 
Fits. 


Seborr- 
hea. 


Number 
Deferred. 


0> 

1 


to 

"3 

S 

CD 
fa 


"3 

EH 


m 

09 

"3 

a 


09 


03 

O 

H 


CD 

"3 
5S 


cu 

a 

S 
a 

1=1 


3 



H 


w 1 3 

CD 5 

S | fa 


"3 



05 

3 


CD 

"3 

a 
fa 


3 




"5 


CD 

"3 
S 

CD 
fa 


"3 

Erl 


CD 

3 
a 


a 


S 


2 



"cO 




3 

£ 
fa 


"3 

H 


CD 
3 


1: 

CO 

e 

CD 

fa 



H 


13 



3 

S 

fa 


3 


H 


« 
g 


6 
a 
S 

CD 

fa 


CO 

"0 

H 


CD 

3 


CO 

S 

CD 

fa 


O 


CD 

"3 


a 

CD 
fa 


"3 
O 

H 




1 


1 


1 


4 


5 




1 


1 


... 1 


1 


1 


3 


4 


1 


3 


4 


3 




3 




11 


11 




3 


3 


2 




2 


1 




1 




1 


1 


54 


211 


205 



(c) Defects for which Candidates were Rejected as Physically Unfit. 



Number 
Rejected. 


Vision. 


Vision and 
Chest. 


Conjunctivitis. 


Hearing. 


Heart. 


Fainting Fits. 


Thyroid 
Enlargement. 


General Health. 


CD 

"3 

a 


CD 

"3 

a 

CD 
fa 


"3 
"o 
El 


09 

75 

a 




"3 

1 
fa 


"3 

EH 


1 


■3 

a 

CD 
fa 


"3 


H 


CD 
■3 

a 


u 

■3 

a 

CD 
fa 


■3 
O 

H 


"3 

a 


.CD 

a 

CD 
fa 


*3 

H 


en 

CD 

"3 

a 


"3 

1 

fa 


CO 


H 


CD 

"3 

a 


"3 

a 

CD- . 
fa 


"3 

H 


OT 

CD 

"3 

a 


s 

■3 

a 

CD 

fa 


"3 



H 


CD 
"3 

a 


OT 

CD 
fa 


"3 


H 


11 


11 


22 


3 


5 


8 




1 


1 


1 




1 


5 




5 




3 


3 


1 




1 




1 


1 


x 


1 


2 



Table VIa.— PARTICULARS OF MEDICAL EXAMINATION FOR ADMISSION TO THE TEACHING 

SERVICE AND TRAINING COLLEGE, 1919. 
(a) General Details. 





Examined. 


Passed. 


Deferred for treatment, 
but subsequently admitted. 


Rejects as Physically 
Unfit. 




Males. 


Females. 


Total. 


Males. 


Females 


Total. 

46 

82 

162 


Males. 


Females: 


Total. 


Males. 


Females. 


Total. 


Candidates for Admission to Service direct ... 
Candidates for Admission to College (long 


33 

78 
77 


46 

99 
273 


79 
177 
350 


18 
38 
40 


28 

44 

122 


15 
34 
35 


17 

51 

145 


32 

85 
180 


6 


1 
4 


1 
10 
8 


Candidates for Admission to College (short 




Z 




188 


418 


606 


96 


194 


290 


84 


213 


297 


8 


11 


19 




31 


69 




50 


46 7 


48 


44 




4 


26 


32 









46 



(b) Defects for which Candidates were Deferred. 



Number 
Deferred. 


Teeth. 


Ilcaring. 


Vision. 


Teeth 

and 

Vision. 


Teeth 

and 

Nasal 

Polupus. 


Teeth 
and 
Gums. 


Teeth 

and 

Hearing. 


Teeth 

and 

Album- 

enuria. 


Teeth 

and 

Tonsils. 


Teeth 
and 
Skin. 


Teeth 

and 

Heart. 


3 
1 


i 

a 

fa 


*3 
O 
H 


o 
"a 


s 

s 

© 

fa 


1 
c 
H 


3 


3 

a 

B 

O 


a 

O 

EH 


© 
- 
53 


a 
fa 


"a 
O 

H 


3 
3 

53 


s 

fa 


a 
O 
Eh 


a 
53 




Efl 

o 

H 


_5* 
3 


eg 

£ 
fa 


S3 

"o 


© 

53 


g 
© 

fa 


3 
o 

H 


c 
"a 
53 


© 

a 

a 

V 

fa 


"5 
o 
Eh 


_© 

a 


© 

a 

© 
fa 


"a 

EH 


1 


a 

« 

fa 


■3 

Eh 


3 
3 

53 


© 

CS 

£ 
fa 


a 

H 


84 


213 


297 


59 


100 


219 


3 


2 


5 


2 


14 


10 


5 


8 


13 


1 




1 


1 




1 


* 1 * « 

) 1 


3 




3 


3 


1 


4 




1 


1 


1 




1 


Teeth 

and 

Dysmen- 

orrhcea. 


Teeth 

and 

Thyroid 

Glands. 


Teeth, 

Skin, 

and 

Thyroid 

Glands. 


General 
Health. 


Albu- 
rn. nuria. 


Dysmen- 
orrhoea. 


Skin. 


Thyroid 

(i lands. 


Spinal 
Curvature. 


Heart. 


Dropsy 

and 

Nephritis. 


Lungs. 


NumVr 
Deferred. 


i 

°a 


a 

a 
fa 


3 
o 
H 


"a 

53 


G 

r 

E 
c. 
ft 


3 

o 

H 


© 


6 

a 

B 
© 

fa 


a 
o 
H 


3 


<5 

a 


3 

o 
H 


© 

3 


V 

1 


03 


© 

3 
m 


u 
d 

6 

© 

fa 


o 
E-i 


U 

53 


fa 


3 

o 

H 


3 

a 
53 


3 

S3 

s 

© 

fa 


O 

H 




© 

a 

s 

© 
fa 


3 
o 
H 


© 

"3 
53 


© 

£ 
fa 


a 
o 

H 


V 

a 

53 


© 

a 

a 

© 

fa 


O 

H 


3 

3 

53 


to 

£ 

© 

fa 


75 
o 
H 


o 

53 


© 

fa 1 H 




4 


4 




1 


1 




1 


1 


1 


ill 

! 


3 




3 




8 


8 ... 2 2... 

1 1 I 


1 


1 




1 


1 




2 


2 




1 


1 ... 


1 


1 81 


213 


297 



(c) Defects for which Candidates were Rejected as Physically Unfit. 



Number 
Rejected. 


Vision and 
General 
Health. 


Teeth and 
Ears. 


Teeth 

and 

Vision. 


Hearing. 


Lungs 


Heart. 


Vision. 


Dropsy 
and 

Nephritis. 


Enlarged 
Thvroid. 

. .1 


Nervous 
Troubles. 


t*„„„ Albu- 
Knee - minuria. 


"3 

53 


£ 

e 

© 

fa 


"3 

H 


£ 

■3 


Females. 
Total. 


1, 


© 

g 
fa 


a 

Eh 


U 

a 

53 


a 

g 
fa 


rt 
O 
EH 


"a 
53 


3 

fa 


3 




c 

53 


CD 

■3 

a 


"3 

Eh 


"5 
53 


CO 

a 

£ 

© 

fa 


a 

O 

H 


0) 

a 



a 

a 


a 
O 

H 


3 

a 
53 


0j 

a 
£ 

© 

fa 


a 

H 


3 

<5 


cu 

a 

a 

fa 


3 


H 


V 

a 
53 




a 
£ 
fa 


a 
O 
H 


a 

53 


'6 
a 
£ 
CD 
fa 


O 


a 
53 


V 

a 

£ 

© 

fa 


rt 



8 


11 1 19 

i 




1 


1 


1 


1 


2 1 1 

j 


1 2 


...| 1 1 

1 




1 


1 


1 


2 


3 J 1 | 2 

! 


3 




1 j 1 


1 1 


2 


1 ! ...1 1 
i 1 


1 1 ... 


1 


1 
1 ! ... 1 



Table VIb.— ADMISSION TO TEACHING SERVICE AND TEACHERS' 

COLLEGE. 

Totals of defects and perconta^)^ in candidates deferred or rejected for the triennial 

period 1917-18-19. 



Admisiion to Teaching 


Men. 


Women. 


Deferred Total. 


Rejects. 






College. 


Men. Women. 


Totals. 




No. 
448 
208 


0/ 
/o 


No. 

1,344 

663 


/o 


No. 

1,792 

871 


0/ 

48-5 


No. 
28 


% K 
6-25 


r o. 

48 


/o 
3-0 


No. 
7G 


7o 
4-2 


Defects — 


148 
30 


33 


507 
45 


37 


655 
75 


36-4 




Teeth and other ... 




Total, Teeth.... 


178 


39-6 


552 


41-1 


730 


40-8 




Total, Medical 


59 


13 


154 


11:5 


213 


11-8 


28 


6-25 


48 


3-6 


76 


4-2 


Vision 


13 

7 
2 

4 

1 
2 

4 
22 

1 

"2 
1 


3 

1-5 
•4 

"•9 

•2 
•4 

•9 
5 

•2 

•4 

•2 

... 


57 
18 
2 
2 
9 
6 
5 
% 
3 

41 
9 
1 

1 


4-2 
1-3 

•1 
•1 

•7 
•5 
•4 
•1 
•2 

3 

•7 


70 

25 

4 

2 

13 

7 
7 
2 
7 

"io 
1 


3-9 
1-4 
•02 

•01 
•8 
•4 
•4 

•4 
•5 


7 
8 

i 

2 
3 

1 

2 
1 
1 
1 


1-6 
1-8 

•2 

•4 

•7 

•4 


26 
C 

b 
1 
1 

2 
1 


2-0 

•45 

•7 

•15 
•07 


33 
14 

io 

3 
4 


1-8 




•8 






Adenoids 




Skin 






•55 




•16 




•2 


Thyroid 


2 

?, 


•i 


Rheumatism 


2 
1 
1 
1 










■1 






Deformed chest .... 


... 



47 



Table VII.- PARTICULARS OF CHILDREN WITH UNSATISFACTORY HAIR CONDITIONS, 

1918 AND 1919. 



Pupils Examined. 


Pupils notified as 
Unsatisfactory. 


Percentage 
of 
Unsatis- 
factory to 

Total 
Examined. 


Pupils Tr«at«d. 


Eoys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 



Per- 
centage 

of 

Pupils 

Treatid. 



-Public Schools. 
1918. 



Metropolitan 

Large Country Towns 

Small Country Towns and Villages. 

Total— All Public Schools .... 



12,630 
12,719 

6,478 



11,400 24,030 

11,775 124,494 

5,735 12,213 



41 
21 

4 



31,827 28,910 60,737 
1919. 



862 

426 

96 



903 
447 
100 



3-7 
1-8 

0-8 



29 
15 

2 



06 1,384 ! 1,450 



0-2 



40 



709 
357 

87 



1,153 



738 

372 

89 



81-7 
83-2 
89-0 



1,199 i 82-0 



Metropolitan 

Large Country Towns 

Small Country Towns and Villages. 



5,534 4,897 

12,153 i 11,623 

7,697 I 6,986 



10,431 
23,770 
14,683 



Total— All Public Schools 125,384 '23,506 '48,800 



17 
23 
10 


350 

434 

75 


373 

457 
85 


3-5 
1-9 

0-5 


12 

10 

7 


280 

! 358 

55 


292 

i 374 

62 


78-2 
81-8 
72-9 


50 


805 


915 


1-8 




693 


! 728 


79-5 



II. — Denominational and Private Schools. 
1918. 





1,436 
1,899 
1,008 


1,427 

2,605 

891 


2,863 
4,504 
1,899 


3 

6 


113 

102 
15 


116 

108 

15 


4-0 
2-3 

0-7 


3 
6 


99 
69 
13 


102 
75 
13 


87-9 


Large Country Towns 


69-4 


Small Country Towns and Villages 


86-6 






Total — All Denominational and Private 


4,343 


4,923 


9,266 


9 


230 


239 


2-5 


9 


181 


190 


79-4 



1919. 





822 

1,753 

695 


766 

2,089 

725 


1,588 
3,842 
1,420 


1 
1 


72 
80 
10 


73 
81 
10 


4-5 
2-1 
0-7 


1 


54 
63 

8 


; 55 

63 

1 8 


75-3 


Large Country Towns 


77-7 


Small Country Towns and Villages 


80-0 






Total — All Denominational and Private 


3,270 


3,580 


0,850 


2 


162 


164 


2-3 


1 


125 


| 120 


70-8 



Table 


vnr. 


—VACCINATION 


RETURNS FOR YEARS 1918 AND 191 


d. 










Examined. 


Pupils found to have been Vaccinated. 


Percentage 




Successfully. 


Unsuccessfully. 


Number of 
Children 

Successfully 




Boy«. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Vaccinated. 



I. — Public Schools. 
1918. 



Metropolitan Area 

Large Cou nl ry Towns 

Small Country Towns and Villages 

Total 



12,030 
12,719 

6,478 


11,400 

11,775 

5,735 


24,030 
24,494 
12,213 


2,875 

2,425 

652 


2,613 

2,354 

541 


5,4 8 | 364 
4,779 ! 427 
1,193 148 


340 
383 
136 


710 
810 
284 


228 

19-5 

9-7 


31,827 


28,910 


60,737 


5,952 


5,508 


11,460 ! 939 


865 


1,804 


18-8 



1919. 



Metropolitan Area 
Large Country Towns 



Total 



Metropolitan Area 

Large Country Towns 

Small Country Towns and Villages 





5,534 
12,153 

7,697 


4,897 

11,623 

6,986 


10,431 

23,776 
14,083 


1,042 

2,409 ; 

471 


930 

2,300 

429 


1,978 j 
4,709 
900 


115 
231 

76 


127 

241 

56 


242 1 
472 
132 1 


18-9 


pns 


19-8 




61 




25,384 


23,506 


48,890 


'3,922 


3,065 


7,587 


422 


424 


846 1 


15-5 



II. — Denominational and Private Schools. 
1918. 



Total 



1,436 
1,899 
1,008 



1,427 

2,605 

891 



2,803 
4,504 
1,899 



336 
271 

178 



4,343 | 4,923 



9,266 I 785 
1919. 



382 
440 
146 

968 



718 
711 
324 



26 
65 
32 



1,753 



Metropolitan Area 

Large Country Towns 

Small Country Towns and Villages 



822 

1,753 

695 


766 

2,089 
725 


1,588 
3,842 
1,420 


152 

277 
50 


115 

311 

39 


267 

588 

89 


3,270 


3,580 


6,850 


479 


465 


944 



123 



18 

34 

6 



32 

84 
24 



58 

14$ 

50 



14) 



14 

33 

5 



Total .... .... ■' u ;},;-.;-;') i>.:.;;,u , * 58 J 52 

III. — All Schools Examined (Public, Denominational, and Private). 



263 



32 
67 
11 



250 
15-7 

17-0 



110 



18-9 



16-8 

15-3 

0-2 



13-7 



Grand Total, 1918 


30,170 


33,833 


70,003 


6,737 


6,476 


13,213 


1,062 


1,005 


2,067 


18-8 






Grand Total, 1919 


28,654 


27,086 


55,740 


4,401 


4,130 


8,531 


480 


476 


956 


15-3 







48 



Table IX.— PARTICULARS OP WORK PERFORMED BY THE DEPARTMENTS DENTAL 

OFFICERS IN 1918 AND 1919. 



(a) Summary of Dental Work done by the Metropolitan Clinic, Travelling Dental Clinics, and 

Travelling Hospital, 1918 and 1919. 





Number of children treated. 


Total number of 
children to cl 


visits of 
nics. 


Average number of visits made 
by each child to clinics. 




Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


1918. 
Metropolitan Clinic 


1,980 

5,875 
874 


1,913 

6,158 

896 


3,893 
12,033 

1,770 


7,301 

9,168 

892 


7,975 

11,107 

916 


15,276 

20,275 

1,808 


3.6 

1-56 

1-02 


41 

1-80 

1-02 


3-9 


Travelling Dental Clinics 


1-68 


Travelling Hospital 


1-02 






1918 Total 


8,729 


8,967 


17,696 


17,361 


19,998 


37,359 


1-98 


2-23 


2-11 






1919. 


1,270 
5*630 
1,147 


1,192 
5,666 
1,088 


2,462 

11,296 

2,235 


5,500 
8,636 
1,207 


5,658 

10,021 

1,177 


11,158 

18,657 

2,384 


4-33 
1-53 
1-05 


4-74 
1-76 
108 


4-53 


Travelling Dental Clinics 


1-65 


Travelling Hospital 


1-06 






1919 Total 


8,047 


7,946 


15,993 


15,343 


16,856 


32,199 


1-90 


2-12 


2-01 







(b) Particulars of the Dental Work 


performed in 1918 and 


1919. 






Treatments. 


Extractions. 


Fillings. 


Extractions 
(average 
per child). 


Fillings 
(average 
per child.) 


1918. 


3,521 

8,773 
183 


13,753 

31,598 

2,447 


9,186 

11,516 

154 


3-5 
2-6 
1-3 


2-3 


Travelling Clinics 


0-9 


Travelling Hospital 


0-08 






1918 Total 


12,477 


47,798 


20,856 


2-7 


11 






1919. 


2,612 

10,370 

635 


8,976 

29,196 

3,975 


6,892 

10,344 

346 


3-6 
2-6 
1-8 


2-8 




0-9 


Travelling Hospital 


0-15 






1919 Total 


13,617 


42,147 


17,582 


2-6 


11 







The influenza epidemic greatly hindered all treatment by the Departmental dentists. The work of the 
Metropolitan Clinic was further interrupted by the destruction by fire of its rooms at the Dental Hospital and the delay 
in finding a temporary location. 

Metropolitan Clinic was closed from 5th February, 1919, to 1st March, 1919, and 19th June, 1919, to 19th July, 
1919. 



Table X.— SHOWING THE WORK OF THE OPHTHALMIC CLINIC, 1918, AND 20th TO 31st 

JANUARY, 1919. 





No. of defective children 
examined. 


Errors of refraction. 


Affections of the 
eyelids. 


Errors of refraction 
and lid defects. 


Other affections of 
the eyes. 


Treatment not 
recommended. 




Boys. 


Girls. Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


1918 


1,410 
86 


1,672 

, 76 


3,082 
162 


1,192 
37 


1,484 
66 


2,676 
103 


148 

47 


118 

9 


266 
56 


19 


25 


44 


28 
1 


28 
1 


56 
2 


23 
1 


17 



40 


20-31/1/19 


1 



The children referred to in this table are those thought to have had eye defects, either as a result of previous medical 
inspections or because of symptoms of eyestrain noted by teachers. 

In addition, a number of children presented themselves with symptoms thought to be due to defects of vision, but nothing 
abnormal was found. 



49 



Table XL— PARTICULARS OF CHILDREN WITH DEFECTS OF SPEECH FOR YEARS 1918-1919. 



Lisp. 



Boys. I Girls. 



Total 



Stutter. 



Boys. 



Girls. 



Total. 



Stammer. 



Boys. 



Girls. 



Total 



Indistinct. 



Boys. 



Girls. 



Total 



Deaf and Dumb. 



Boys. 



Girls. 



1918. ■ 
(a) Public Schools. 
Number of children examined :— 31,827 boys, 28,910 girls; total, 00,737. 



Metropolitan ., i 17 

Large Country '> 107 

Small Country j 50 



13 

118 
37 



Total 174 j 168 



30 


76 | 


225 


06 . 


87 


26 


342 


168 



19 


95 


72 1 


17 


89 


141 


66 


18 


84 


24 


6 


30 


100 


64 


5 


31 


17 


9 


26 


87 


28 


42 


210 


113 I 


32 


145 


328 


158 



207 
164 
115 



(b) Denominational and Private Schools. 
Number of children examined :— 1,343 boys, 4,923 girls; total, 9,266. 



Metropolitan j 1 1 

Large Country 11 | 21 

Small Country ...'.'.'.'... ".... 5 2 



Total ..... 17 



24 



2 


10 


5 


15 


32 


9 


8 


17 


7 


6 


3 


9 


41 


25 


16 


41 



16 
3 
6 



16 


14 


10 


3 


21 


17 


7 

■ • 


8 


4 

• 



486 



24 
38 
12 



11 26 ! 43 I 31 ! 74 I 



(c) Travelling Hospital Schools. 
Number of children examined : — 2,108 boys, 1,941 girls; total, 4,049. 



Public Schools 



(d) All Schools (Public and Private). 
Number of children examined :— 38,278 boys, 35,774 girls; total, 74,052. 
All Schools I 196 I 194 I 390 I 194 [ 58 I 252 [ 154 I 30 [ 190 [ 402 | 212 



614 



Total. 



Is 


4 

1 


.. 2 ! 


6 
1 


1 




1 1 


15 1 

1 1 


3 


18 1 
1 1 


"29 ; 

2'| 


19 

4 


48 | 
6 | 


'1 1 ... 


1 


lal and Private Schools 








Total 


5 


2 ! 


7 


1 




1 1 


16 1 


3 


19 1 


•31 j 


23 


54 1 


1 | ... 


1 



1 I 2 



Total number of children with defects of speech, 1,448 (boys, 917; girls, 501), 

1919 

(a) Public Schools. 

No. of children examined :— 25,384 boys and 23,506 girls ; total, 48,890. 



Metropoli tan , >. Q 

Large Country , ' 90 

Small Country 32 

Total 137 



(b) Denominational and Private Schools. 
Number of children examined : — 3,270 boys and 3,580 girls ; total, 6,850. 



Metropolitan ... 
Large Country 
Small Country 



Total 



Public Schools 



(c) Travelling Hospital Schools. 
Number of children examined : — 1,730 boys and 1,624 girls; total, 3,354. 



(<l) All Schools (Public, Denominational, and Private). 
Number of children examined :— 30,384 boys and 28,710 girls; total 59,094. 
All Schools | 155 I 131 | 286 I 121 I 35 I 150 I 107 i 31 [ 



12 


21 | 


36 | 


7 


43 


21 


2 


23 


63 


33 ' 


96 


81 


177 


51 ! 


20 


71 


37 


10 


47 


99 


56 


155 


20 


52 


22 j 


3 


25 


20 


11 


37 


113 


42 


155 


113 


250 1 


109 [ 


30 


139 


84 


23 


107 


275 


131 ! 


406 



4 





4 


3 




3 


5 


2 


7 1 


17 


3 


13 


15 


28 


5 


5 


10 


10 


4 


14 


9 


10 


1 


3 


4 


3 




3 


3 


1 


4 j 


11 


9 


IS 


18 


36 


11 


5 


16 


18 


7 


25 I 


37 


22 



20 
19 

20 



59 



s 


... i l 




1 


5 


1 





19 
3 


4 


23 


ial and Private Schools 




... 


3 


Total 1 ... 




... | 1 




1 


5 


1 


o , 


22 


4 


26 



138 ; 334 I 157 I 491 



Total number of children with defects of speech : — 1,071 (boys, 717; girls, 354). 



Combined totals, Stutter and Stammer : — 304, -5 per cent, (boys, -75; girls, -24). 



Table XII.— ABORIGINAL SCHOOLS. 
(1.) Medical Inspec<i->n Results, 1918 and 1919. 







1918. 




1919. 




Boys. 


Girls. 


Total. 


Per- 
centage. 


Boys. 


Girls.. 


Total. 


Per- 
centage, 




39 

34 
31 
10 
10 


38 

32-5 

34 

19 

10 


77 
60-5 
*65 
35 
20 


53-8 

57-1 


120 

98-8 
101 

52 

13 


130 

112 

101 

40 

19 


250 

210-8 

202 

98 

32 








Number of Pupils examined 






48-5 




326 



11833-D 



Numl er of sclioo's examined, IMS, 5 — l^lfi, M. 
* Of tliis number 9 roys and 15 tfhls were examined a-id treated by the Travelling Hrijpit.il. 



50 • 

Table XII — continued. 
(2.) Details of Defects. 



All skin and teeth defects received treatment, and 1 adenoid and 2 tonsil operations. 

(3.) Particulars of Children with Unsatisfactory Hair Conditions — 1918, 1919. 



(4) Vaccination Return for Years 1918, 1919. 





Number Defective. 
1918. 


Number Defective. 
1919. 




Boys. 


Girls. 


Total. 


Boys. 


Girls. Total. 


Eyes — 


1 

1 


2 


1 
3 


3 


6 

i 


9 






1 






2 


2 


4 


3 


7 


10 




Ears — 


... 


1 


1 


1 


4 


a 














1 


1 


1 


4 


5 










... 




1 


1 


2 






Total 




1 


1 


2 


5 


7 






Nose and Throat — 


3 


3 


6 


6 
7 
7 


2 
3 
3 


g 




10 














Total 


3 


3 


6 


20 


8 


28 






Teeth- 



6 


2 
7 


2 
13 


1 
28 


3 

24 


4 




52 






Total 


6 


9 


15 


29 


27 


56 






First Teeth only 


18 


18 


36 


43 


45 


88 






Deformities — ■ 




1 


1 




... 
















,, Arm and Leg 








Total 




1 


1 




... 








Other defects — ■ 
Skin 


4 
2 


2 
2 


6 
4 


2 
14 

i 
1 

2 


6 

i'6 
'5 


8 


Hernia 






24 






Defective nutrition 


6 


Defective speech 


1 








2 






Total .-. 


6 


4 


10 


20 


21 


41 









• Aboriginal 
schools. 


Pupils examined. 


Pupils notified as 
unsatisfactory. 


Percentage 

unsatis- 
factory to 

total 
examined. 


Pupils treated. 


Percentage 
of pupils 




Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


treated. 


1918 


31 
101 


34 
101 


65 
202 


... 


5 


5 


2-4 


... 


3 


3 




1919 


00-0 







_. 








Pupils found and have been vaccinated. 


Percentage 


Aboriginal 
schools. 


jaxamineQ. 


Successfully. 


Unsuccessfully. 


number of 

children 

successfully 




Boys, 


Girls. 


Total. 


Boys. 


Girls. 


Total. 


Boys. 


Girls. Total. 


vaccinated. 


1913 

1919 


31 
101 


34 

101 


65 
202 


9 
6 


15 
6 


24 
12 




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1 


96 per cent.. 

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PART II.— SCHOOL ANTHROPOMETRY. 

Foreword by the Principal Medical Officer. 

Dr. Harvey Sutton, O.B.E., M.D., D.P.H., B.Sc. 

The life history of the human organism and of humanity is the 
central interest of most organised knowledge. While even the sciences of 
physics, chemistry, geology may be correlated as studies of man's 
environment, a direct personal attack is found in anthropology, educa- 
tion, health, and social science (statistics). 

In physiology -and pathology the individual absorbs most of our 
attention, while in vital statistics and social science we consider humanity 
in bulk, the individual being lost in the mass. Generally speaking, the 
larger the mass the more accurate is the result. 

The human being is a complex, produced by the mutually inter- 
dependent action and reaction of environmental and inherited factors. 
At a certain period of the life history, during a given interval of time, 
a change occurs under the action of these forces. The rate of change, as 
well as the resultant, is the function, both of the external reacting forces 
and Of the internal capacity for reaction, and is the test of both. Growth 
■ — and, better still, rate of growth — is therefore an invaluable test both of 
the individual and of his surroundings. Keeping one of these, constant 
comparison demonstrates the variations produced by the other. The 
individual is judged by comparison with the normal standard obtained 
by statistical analyses of bulk samples drawn from the same period of 
the life history and living in the same surroundings. Conversely, sur ■', 
roundings may be tested by the difference in reaction of- similar human 
bulk samples living under the differing conditions. 

The educational period of human life history stands out from the 
adult period by this very character of growth. Estimates of physical 
growth form our best criteria of the ultimate effects of the mass of 
influences operating on every individual. Records are made of stature 
or of bulk or of head dimensions and capacity, of chest diameters and 
expansion, and collected for the different ages, sexes, districts. Reliable 
standards such as these for the average child are vitally essential for the 
proper physical judgment of every individual child. 

As mentioned above, growth is the test, not merely of the environ- 
ment which stimulates and guides it, but also of the hereditary impulse 
which forms after all the force in the background. Judging humanity in 
the mass we may use the term racial impulse. The observation of any 
change, physical or otherwise, in the successive generations of the Aus- 
tralian born, is or should be of compelling interest to every one, and 
most of all to our statesmen. Parents are asked a simple question as to 
the birth-place of the child, his parents and grandparents, and children 
then fall into certain main generations of immigrant (foreign), Aus- 
tralian born of British or oversea parents, the Australian born of 
Australian-born parents, and finally the Australian born with Australian 
grand-parents. Intermediate types occur, of course, of one Australian 
parent, one overseas parent, &c. \ ,., ^ .... ■. 



57 

Allusion to the Statistician's tables and graphs, for example, 
shows that the individual Australian boy and girl are better physical 
specimens than the Australian born with one British parent, and the 
latter than the child with both parents born overseas, judged by the 
criteria of height and weights and whether we compare them in metro- 
polis, town, or country. 

Again, it is clearly shown that the rural child of whatever Aus- 
tralianship outstrips the large country town and the metropolitan child, 
between whom the differences are but slight. 

Taking the totals for the State the numbers (about 100,000 boys 
and 100,000 girls) are adequate for the adoption of standards of height 
and weight for general use and for the study of growth. 

To the school medical officer the study of growth, both physical 
and mental, is the basis of our work. 

Growth not only constitutes the fundamental difference between 
the child and the adult, but is our best test of health from birth, on 
through school life, to late adolescence. 

Here in Australia we dealt with a remarkably homogeneous white 
race of European descent. It is outstandingly British in origin — the 
most completely British in the Empire, not excepting the population of 
the British Isles themselves. 

The essentially democratic basis of our social life has minimised 
those class differences so marked in the older countries of the world. 
Industrial, commercial, professional in the city, shearer and farm hand, 
farmer, miner, and grazier in the rural areas absorb all except a small 
squattocracy and plutocracy forming the apices. But transition from 
class to class is easy. Education is free from kindergarten entrance to 
graduation for the supernormal. The population is remarkably restless, 
perhaps a relic of the enterprise of our pioneers. The freest interchange 
occurs between states, between town and country, and between adjoining 
districts and towns. It is not infrequent to find every year a migration 
of one-seventh of the school attendance to and from another school. The 
'majority of adults between 20 and 45 find their way to the metropolis 
some time or other, the children and old people remaining in the 
country. This influx into the city is nearly twice as marked for women 
than for men. 

Viewed from a minimum standpoint sheer poverty endemic in 
London, Liverpool, or Glasgow is purely sporadic with us and chiefly 
limited to the quarters of the alien underworld seen in all seaport 
capitals. 

Still the world-wide problems of housing, high cost of living, arti- 
ficial feeding of infants, mentally deficient chilldren, &c, &c, are ever 
present, and similar physical wastage occurs as was revealed during the 
conscript examinations in England. The Australian figures for recruit 
examinations -have not been properly analysed, but where three out of 
nine were Al class in England about four in every nine were up to stan- 
dard here, and the C3 class was much smaller. The predictions of school 
hygienists and the findings of 50 to 60 per cent, defective in school have 
thus been verified and the defects in the years of school life proved to be 
the basis of the later physical deterioration. ^_ 



58 

The outstanding differences in Australia are not so much here- 
ditary or social, but rather district and climatic. Gold has been respon- 
sible for the appearance of populations in the most unlikely places, e.g., 
in areas with less than a 10-inch rainfall, where water has to be brought 
by camel or railway tank. Material wealth, combined with the striking 
racial policy of ' ' white ' ' Australia, has begun one of the most interest- 
ing of human experiments — a large working white (and British) popula- 
tion living within the tropics (North Queensland). 

In the State of New South Wales the area under control of this 
branch, and covered once every three years, is not merely extensive, but 
includes a great variety of climates. The 700 miles of coastline take one, 
as we pass northwards, from a cool temperate to a subtropical region. 
Meteorologically, we change from winter rains to monsoonal, wet 
summer seasons. 

Travelling westwards from the narrow coastal plain we cross 
ranges rising abruptly to 2,000 or 3,000 feet to tablelands, stretching 
from Victoria to Queensland, rising in the south in mountains over 7,000 
feet high. Here we get Kiandra with snow on the ground for months 
every year and a 70-inch rainfall. The slope westwards is gentler, and 
enters a great wheat belt to level out into the great western plains within 
the watershed of the Darling, Lachlan, Murrumbidgee, and Murray, the 
southern part, the Riverina, being one of the most prosperous parts of 
the State. Far to the west again, not yet even in railway communication 
with Sydney, is a metropolitan industrial population dumped on a 
comparatively small area of enormous mineral deposits — Broken Hill. 

The district incidence of health and disease has hardly yet been 
glimpsed. Two striking special examples are being studied. Goitrous 
areas occur on or near the tablelands, and trachoma occurs in western 
and nor '-western areas. These are ai: present being mapped with a view 
to further investigation. The State itself has been divided for future 
work into three from north to south and four from east to west. 

A. NORTHERN — 

1. North Coast. 

2". Northern Tableland (New England). 

3. North-west Slope. 

4. North- Western Plains (Darling River). 

B. Central — 

5. Coast Central. 

6. Central Tableland. 

7. Western Slope. 

8. Western Plains (Macquarie and Lachlan Rivers). 

C. Southern — 

9. South Coast. 

10. Southern Tableland. 

11. South-west Slope. " 

12. Riverina. 



59 

Not included in the above are three special areas, viz. : Metro- 
politan (Sydney, Newcastle, and Broken Hill); Far West (the Never- 
Never country) : Federal Territory (in the Southern Tablelands). 

It is sought to survey the characteristics of each district and 
further divide into sub-districts, and seek to correlate it with the findings 
of the examination of children. Soon it should be possible to realise 
the effect of causes, which often vary per district, yet are acting on a 
homogeneous population. Further infectious diseases and anthro- 
ponetric figures should be collected per district, and so a comparison be 
possible. 

The special features of districts may further guide methods of 
school architecture and of field sanitation. For example, following the 
test of fly contact, rural districts where the soil is sand or loam, the 
rainfall (low) the sole water supply, and ordinary above-ground tanks 
the receptacle for roof-collected water, properly constructed cesspits 
with flyproof automatic covers are by far the best arrangement, and 
from every aspect quite unobjectionable. 



60 



The Scientific Study ol Malnutrition in School Life. 

The term Science tends to be applied first to the pure sciences, 
where knowledge is now sought independent of ultimate utility, and then 
to the applied sciences, where utility governs interest, and an immediate 
practical result is primarily desired. Historically, however, even the 
pure sciences began with this utilitarian bias. The alchemist sought for 
the philosopher's stone which would transmute all base metals to gold. 
The stargazer watched for celestial portents to foretell the future to cast 
a nativity or predict the fate of nations. Archimedes pondered during 
immersion concerning a tricky deal in royal crowns. All helped to lay 
the foundation of chemistry, astronomy, physics, sciences, which nowa- 
days almost disdain their utilitarian ancestry, and, like the artist's art 
for art sake, strive for a serene atmosphere not understandable by the 
vulgar and profane and other than popular. 

The hygienist, on the other hand, should set his face against this 
stoic attitude, and seek to show how science, in its organisation of 
accurately acquired knowledge, may illuminate and make plain the world 
we live in, and daily solve its problems. 

Still, the rigidly practical aspect has ever been a dangerous one. 
Experience in science shows that the means justifies the end. Chance 
loves Art and Art loves Chance has so often proved true. x\n Italian 
professor's helpmeet's interest in frogs' legs hanging out on a metal 
verandah, Galileo absentmindedly watching the swinging choir-light on 
the Pisan Cathedral seem strange origins for electrical dynamos or for 
pendulum chronometers ; or, to take a more recent example, a million- 
aire 's fad for collecting every known form of the unnecessary but 
ubiquitous flea may rightly be claimed as our basis for the study of the 
prevention of plague. Again, the test of the hygienist and scientist is 
like the artist. His treatment of his background — Pathology of recent 
years, for example, has progressed largely as a result of the study of 
the physiology of the background. 

From such striking examples I wish to turn to the experience of 
school hygiene. The health student, in his insatiable thirst for any or 
every form of knowledge which may conceivably lead to a new practical 
result, tends to scientific immorality, and, like Dumas' Miladi, seeks to 
be all things to all men. Yet, with the strictly practical attitude is 
growing up of necessity the desire for organised knowledge, for science 
in its purest sense, even though the pious hope is always present that 
some day, somewhere, somehow, this knowledge will prove of direct 

value. 

School medical work is at present expanding from the utilitarian 
aspect, and realising that science, as applied to school medicine, by its 
broader view, its study of underlying causes, its unrivalled method of 
organising knowledge, is to be our basis for present and future develop- 
ment. 

From the point of view of pure or applied science, hygiene is both 
or neither — like Mahomet's coffin — it is suspended, though not, I hope, 
inanimate, between earth and heaven. j- 



61 

It is. this transition stage with which I purpose to briefly deal, and 
to discuss the intrusion of pure science into our work, and to outline 
possibilities for the immediate future. Though, like any business enter- 
prise, and not unforgetful of our utilitarian origin, we will keep a sharp 
eye on the direct value demanded far too stringently by the keepers of 
the public purse. School medical work started out and continues 
primarily with a definitely curative basis. Our first duty is to discover 
defective children, and our second to remedy, or at least to induce the 
remedy, of defects. A routine inspection or better examination of all 
children either at every age or only at certain ages is carried out. 

Experience already shows that the merit of such observational 
work is in inverse proportion to the narrowness of the attitude of the 
examiner. The broader the schedule to be filled in the more satisfactory 
even to the testing of defects, while the reaction on the examiner, the 
mental depressing effect of limited rigid routine, is largely neutralised. 
Our aim here must be scientific, i.e.,, the classification of children not 
merely into adenoid types, Sec, but into all classes, not merely of the 
abnormal, but of deviations from the average within normal limits. How 
else are we ever really to establish the limits of the normal, which is the 
guiding line and real justification for suggesting advice and treatment, 
and how fascinating and absorbing becomes our interest in the thousand 
of human organisms we handle! 

The value is indirect chiefly, yet direct results in accurate diag- 
nosis may be claimed. The Hypopituit and the Idioglossia, both physio- 
logical deviations, which, without treatment, return to normal, I have 
seen in several instances under treatment, medical or educational, for 
feeble-mindedness, being mistaken for cretinism in the former and con- 
genital feeblemindedness in the latter. 

■ " • — v *-i 

This study of the borderland of human physiology and pathology, 

whether physical or mental, is making great strides, and new problems 
are already evident. One vast problem, exceedingly annoying because of 
our helplessness, is that of malnutrition. Take a simple illustration. A 
medical officer in the field sees a child stunted in growth and below 
standard, not only in height and weight per age, but, what .is more 
important, weight per height. It is often described by parent and 
teacher as delicate, and its fatigue limit "is low. Some pallor due to 

:' ' . ■" LRI19JBCS Cf.t'T^H ,i ■'.:■..;■ FC 

anaemia is often, but not necessarily, present. What action is possible? 
Many with moderate anaemia are notified to the parent as " general 
health." The type of family doctor or hospital resident exists too 
frequently who simply tells the parent that " there is nothing wrong 
with the child." He really means " no gross organic disease is present 
for which I can prescribe or operate;" but he does not put it that way. 
The parent's time and money are thus wasted; but, what is worse, no 
benefit is obtained by the child. Yet, if we are to believe that, just as 
typhoid is the test of municipal sanitation, so tuberculosis is the test of 
rational nutrition, we must do something. At any rate, a pamphlet of 
information on the nutrition of children should be forwarded to the 
parent of the child — and better to all parents — but no one yet has had the 
courage, even if they have the capacity, to write such a pamphlet. And 
what is the writer to talk about? What do we know of the causes of 



62 

malnutrition, and what standards have we for our diagnosis? Some 
immediate influences have been defined, and practical efforts based 
thereon have been more or less successful. Food — sheer quantity— 
naturally is first considered in relation to poverty; and so England and 
Wales, before the war, provided school meals to one-twelfth or so of the 
school children. Such a feature must have had a distinct additional 
value in teaching parents the value of kinds of foods; and this latter 
appears to be an Australian need, where in the past unsatisfactory 
quality, not insufficient quantity, seemed to be a just criticism of child- 
feeding. Doubtful feeding shows up first in children who are over- 
worked outside school hours — child labour, as in dairying districts — 
chiefly affecting the neglected child. Dr. Jean Greig, in industrial 
suburbs of Melbourne, showed that lack of fresh air in bedrooms was 
responsible for frequent anaemias of a moderate but definite degree. 

This finding led the way to establishment of an open-air day 
school, with mid-day meal. Experience here seemed to show in most a 
return to normal standard of weight in about six weeks, with some 
improvement in anaemia, as much or more than could be expected of a 
measure that attempted to neutralise while it did not remove the 
antecedent cause of the condition — bad housing. The children slept at 
home, and during the week-ends, when the school ceased its influence, 
always lost weight. It certainly justified its existence and a further 
extension of the measure; but it is obvious that residential open-air 
schools are necessary if we are to get the full effect of open-air 
conditions. 

Beyond these two causes very little can be recorded. It will be 
noted that these causes have, so to speak, recommended themselves 
because of the possible remedy close at hand. A broader investigation 
is required. Other claims require most careful consideration. The 
dentist would assign dental caries as a main cause of malnutrition and 
its associated anaemia. While individual examples can be cited, is it a 
dominant cause in children? Ninety-five per cent, and more of children 
are subjects of dental caries, yet subnormals form a low proportion. If 
caries is present, when will it affect general nutrition? Foods, especially 
children's foods, nowadays reqiiire little mastication, and the salivary 
failure is probably met by the pancreatic " all in "action on starches and 
other food. Again, septic material is disinfected by the hydrochloric 
acid of the stomach. Pyorrhea, that untamed disease of adults, whose 
ravages frequently result in anaemia, is almost unknown in school life ; 
and while abscesses are not rare, they are so fully combated by the body 
that fistulae are rare. Disabled mastication from tender teeth may 
reduce eating power, but appetite usually rises superior to this. While 
dental caries is probably to be regarded as a most important cause of 
adult conditions (dyspepsia, anaemia, and rheumatoid arthritis, &c), 
and it is probably a contributory rather than a main cause of child mal- 
nutrition. The worst sets of teeth tend to be found in the ill-nourished, 
while good teeth are most commonly confined to the children above 
standard. This and the future risks fully justify the fullest dental 
treatment for school children, but by no means solves the problem of 
nutrition. 



63 

Besides teeth, adenoids by their disturbances of sleep, visual 
defects by headaches, may upset nutrition. In residential open-air 
schools a favourable reaction is not obtained in children with adenoids 
till operation removes the defect. Nor should the proneness of children 
to infections by intestinal parasites be forgotten, e.g., hookworm in 
Queensland and thread-worm in Victoria. Again clinical experience 
sets before us striking examples of the effect of infectious diseases. A 
child has an attack of measles, perhaps with broncho-pneumonia. The 
parent, a few months later, says it never semed to pick up afterwards — 
was mopey and did not play about like other youngsters, became thinner, 
lost appetite, and now, on examination, we find tuberculosis present, 
whether pulmonary, meningitic, abdominal, arthritic, or general. 

Yet in school experience these cases, though they continually crop 
up at children's hospitals, are either few, or else in some way elude the 
school medical officer, perhaps because the incidence is before 7 years 
of age. At the same time, one must admit the role of infectious diseases 
in the school life of the child still awaits investigation. Nor is it a light 
one, e.g., communicable diseases in New South Wales account for the 
absence every year of one-fifth of the enrolment for about one month. 
This includes, it must be at once admitted, many sent home as contacts, 
but again many of these do contract the disease. Nor must we limit our 
consideration to school life. Over 70 per cent, of children have had 
measles before 6 years of age, the ordinary school entrance age, and just 
the very period when measles not only scores at close range, but gets 
its maximum long-distance effects in malnutrition and tuberculosis. 

Or to take another disease most elusive to school diagnosis — 
congenital syphilis. Obvious cases are the rarefies of- our work. Where, 
then, are the 15 per cent, of the hospital population, or the high percent- 
ages in those dying in infectious diseases hospitals ; yet this disease we 
know clinically scotches all human development. The further back we go 
more and more antecedent possibilities open up. In the first two years 
of life what a fund of digestive troubles and insolvency of nutrition 
appear under the title of rickets, which, judged by skeletal changes, is 
still discernable in 25 per cent, or more of school children, and here 
Health Authorities have to deal with the vast subject of infant feeding, 
to proclaim the triumph of breast-feeding and the pre-doomed failure of 
artificial feeding. But even here, though Mellanby's experiments on 
puppies are unmistakeable as to the deficiency in feeding, the exact 
importance of overcrowding and bad housing as a deciding or even 
originating factor is by no means settled. Further, our search must go 
back to its furthest limit. Ante-natal hygiene is still a largely unexplored 
region, full of the greatest possibilities. 

Finally, there is our background behind, and supporting all of 
the above factors — social and economic questions of the relations 
between the sexes, the living wage, housing, and even religion the basis 
of morality and in the past of hygiene itself. 

Such is a brief consideration of obvious possibilities in causes 
incident in the homes and ordinary life of the children independent of 
their school work, yet if an educative pamphlet is to go out it must 
consider the problem as a whole, At every turn we are faced with 



6i 

possible causes, but know but little of probable causes, yet these must be 
our chief attack, and these should be evaluated in Australia, as has been 
attempted in England. 

Discovery of malnutrition bears an immediate direct criticism. 
When are we to say a child is the subject of malnutrition? At present the 
matter is left entirely to the personal attitude of the medical examiner. 
The figures as to anaemia in the various States vary remarkably, and 
are obviously inaccurate. The notification side has undoubtedly affected 
this. Trustworthy standards are now available of height and weight of 
children in New South Wales taken from over 200,000 children. It is 
proposed to utilise this by furnishing every school medical officer with a 
scale showing appropriate weight for height per age. The individual 
nutrition is probably best tested by the weight per unit of height lbs. per 
inch, or better, kilos per centimetre. This may be applied by simply 
taking the weight per height, at first independent Of age. 

Estimation of deficiency must be in percentage, not actual number 
of lbs., and a 10 per cent, deficiency be regarded as approximately the 
limit of the normal — e.g. : Age, 11 years, i.e., 10 years and nine months 
to 11 years and two months; height, 53^ inches; weight, 66 lb.; subtract 
1/10, equals 59| lb. limit of normal. Dreyer regards 5 per cent. (1/20) 
loss or gain as possibly abnormal, 10 per cent. (1/10) probably and 15 
per cent. (1/7) approximately certain. W ; here weight is taken per 
height, independent of age, 10 per cent, is a safe figure for normal 
deviation limits. 

The combination with anaemia or with nervous disturbances is 
most important. Some people are quite healthy though sparely built. So 
often we find children with chubby faces and good colour and very 
sparely built trunk — the lean kine. Anamiia is of marked confirmatory 
value, and the 10 per cent, reduction in weight with anaemia, even of 
moderate degree, is always worth special attention. 

Here the whole question of school anthropometrics crops up. 
Measurements of the human body may be divided into two types — (1) of 
structure, (2) of capacity. In school work we want, not less, but more 
and better statistics. Standards are unsatisfactory till numbers run 
into the hundred thousands. Most of the measuring work done is 
desultory, and, when recorded, not collected by the statistician. Further, 
sufficient local variation occurs as to render figures for other parts of the 
world untrustworthy here. 

Structural figures usually taken are height in stockings, weight 
(without outer clothing and boots), chest circumference, sometimes chest 
diameters (a new but more accurate measure), and head Idiameters. 
Curiously we have no Australian standards of sitting height — yet this 
should dominate the design of school desks. Further, in development it 
should be remembered that the body is built on segmental lines, and is 
head and trunk only, the lower limbs being analogies of the upper 
limbs, and both mere appendages. We should really take height with 
arms stretched upwards in relation to full body weight. 

Sitting height has been shown recently to bear a strict relation- 
ship to bowel length and area, and to be the best guide to quantity of 



65 

food in infants. It may be our best guide to general nutrition. The one 
difficulty is that the weight of head and trunk, independent of limbs, is 
obviously unobtainable. 

Again, vital capacity figures, though recorded, have not been 
collected and published. Dreyer, in his assessment of physical fitness, 
lays distinct stress on this, especially in relation to early tuberculosis. 

For a proper physical estimate we should know — (1) stature, (2) 
sitting height, (3) weight, (4) area of cross section of chest, (5) vital 
capacity, (6) skull capacity, (7) dynamometer grip. Blood pressure, 
diastolic as well as systolic, is being followed by special investigators as 
a delicate test of school fatigue. Haemoglobin percentage might well 
receive closer attention. While in special types, e.g., feeble-minded, the 
Wassermann test ought to be conducted, and in doubtful chests the 
cvt'reaction for clinical tubcrcu'ous disease employed. 



14833— E 



66 

bur- :.■- ■ -•<• ■ siio 

Rate of Growth of Australian Children. 

Harvey Sutton (O.B.E.), M.D., D.P.H. (Melh) ■ .Bis&^pJtmk) 

Very little attention has been given to estimating growth on a,, 
strictly scientific basis, e.g., the force of gravitation is expressed, not 

'■-■ ' '-- ">:V'UO "''MiUlC F "''• ■'- 

by the total distance travelled in a given number of seconds, nor 
by the distances traversed in successive seconds, but by rate of 
acceleration. The growth force is best estimated, not by the actual 
height or weight reached at a given age, nor even by actual yearly 
increments, but by rate of growth, i.e., the percentage obtained by divid- 
ing the gain for the yearly or half-yearly interval by the height or 
weight at the beginning of the interval. A graph constructed on these 
lines reveals very striking facts only dimly realised heretofore. 

The usual graph of total heights or weights is described as 
showing a superiority for the boys up to Hi, then of the girls till 151, 
the boys then leading again. The girl ceases growth at 18, the boy going 
on for a few years more. 

This is correct, but gives no real idea of rate of growth ; the graph 
of percentage growth shows that girls even at 9 years of age are growing 
as fast, if not faster, than boys, and continue at a definitely greater and 
increasing rate till a maximum is reached at 13; then comes a very 
distinct drop in growth, the rate falling away rapidly to a very small 
figure. The boy, on the contrary, at the very same age, 13, rapidly 
increases in rate of growth, reaching his maximum at 15| years, and 
then in turn rapidly subsiding. The abruptness of the change of rate 
and its complete reversal in the two sexes is strikingly associated with 
the few months which correspond to the obvious onset of puberty, 13^-1 
(the periodic flow in girls and the appearance of testicular secretion of 
seminal fluid in boys). 

Growth in the human is dominated we know by the life-history 
of ductless glands, whose internal secretions appear to establish a 
balance and to provide the required stimulus to growth, both physical 
and mental. Anomalies of the thyreoid or the pituitary glands are 
especially associated with alterations in growth. Deficiency of thyreoid 
means dwarfism, both stature and intelligence being stunted, weight per 
inch being usually increased. The supply of the regular amount of 
thyreoid produces in these cretins rapid increase and a near approach 
to the normal height with lessened weight per inch. A further increase 
of thyreoid intake apparently does not further affect growth in height, 
though weight may be further reduced and signs of nervous over- 
stimulation appear. Again, the adult losing her thyreoid increases in 
weight and becomes stupid and dull. 

The whole rate of chemical change in the body, as shown by body 
temperature, by general activity, and by growth in height and reduced 
storage of unused food, appears dominated by the hormone or chemical 
messengers produced by this thyreoid gland. The pituitary suprarenal 
and probably other associated glands appear to supplement or cheyk 
thyreoid action. . : . i 



67 

Active throughout life, it is especially active just at and after 
puberty, with a very marked sex difference. In woman the thyreoid 
visibly enlarges, the physiological enlargement having wide limits and 
lasting during adolescence with gradual diminution. Still greater 
enlargement of a disease type is relatively common in women, the dis- 
tressing exophthalmic goitre, and produces severe effects, the trembling, 
eye-starting, palpitating condition exactly corresponding to the state of 
fear. 

In men these ordinary or extraordinary enlargements are 
rarefies. 

It would appear that the onset of puberty has a remarkable 
influence on the human rate of growth. In the girl it abruptly and 
rapidly diminishes ; in the boy it abruptly and rapidly increases. 

One may suggest that the thyreoid (and associated glands) now 
has in the female a new activity, a duty that absorbs all its action, the 
stimulation of the reproductive system of glands and through them 
psychological changes of a far-reaching character. We know that 
enlargement of the thyreoid is common in pregnancy, and the association 
must be a very close one. The ovarian internal secretion does not 
appear to influence growth of the woman to any marked extent. In the 
male, on the other hand, a similar stimulus is given by the thyreoid to 
the reproductive gland, but in this instance the testicular hormone is 
noted for its influence on growth, and particularly on cartilaginous, hair, 
and muscle tissues. The larynx lengthens with prominence of the 
Adam's apple and a drop of an octave or more in singing voice; the 
beard and body hairiness appear, and brawn and virile vigour develop. 
In other words, the sex differences latent in children now show them- 
selves. 

It would seem, therefore, that in childhood physical growth is 
primarily a function of the thyreoid gland (and its associates), that at 
puberty this duty is largely handed on to the reproductive organs, and 
growth at once becomes part of the secondary sexual characters. 

In confirmation of this finding, as shown by the study of the rate 
of growth revealed by percentage increase, let us adopt another method 
more difficult but extremely fascinating, which also reveals rate of 
growth. 

My attention was drawn to this by the most interesting tables and 
graphs in the Commonwealth Year Book, in which Mr. Knibbs has 
published the results for the height, weight, and chest measurements 
of cadets, 1912. 

The numbers are adequate, 120,000 — nearly 100,000 being in the 
ages 131-17. For each half-yearly period a curve is constructed giving 
the percentile frequency at that age of any given height taken from a 
table in which the proportionate distribution according to height in 
inches of 10,000 children at each age-period is given. The graph repre- 
sents these percentiles as ordinates and the height in inches as abscissae. 
The curves resemble the typical frequency curves common to all human 
measurements, and first, I believe, established by Quetelet. On closer 
examination negative skewness in the older and positive skewness in 
the younger curves can be distinguished as pointed out in the Year Book. 



68 

But, in addition, a very curious point develops ; the mode, instead of 
remaining at the same proportionate frequency at each half-year, 
steadily becomes less frequent (as to height), and is least frequent and 
the curve is flattest at 15|-|. Correspondingly a massing-up occurs with 
an increasingly high mode at 18. What explanation can be given for 
these alterations in curve! I think we must associate this with rate of 
growth. Just as in a race, as the pace increases the field spreads 
out and proportionately fewer travel the average pace, the greatest 
spread occurr'ng at the period of fastest pace; so, at the most 
act've s'age of g owih, under the whip of the thyreoid-testicular 
stimulus, the percent les and mode are lower and cover a greater 
difference in heights, to close up again as the race terminates. 
At the beginning the longer spread will le in front, as the faster 
got away from the field ; at the end the tail will be the longer, 
equalling positive and negative skewness. If, as seems rational, a faster 
rate of growth conditions this lowering of the mode and spreading of 
the curve, we may use it as a method of testing rate of growth. The 
cadet figures correspond closely with the finding of the 15|-16 age as the 
maximum growth period. 

I have attempted to construct a similar graph for Sydney boys 
and girls from 6-16, Australian-born of Australian parents, over 18,000 
boys and 18,000 girls being recorded. Only heights were at my disposal, 
as weights have been collected only in relation to height. The curves 
provide, I believe, confirmatory evidence as to the date in the life-history 
of maximum growth; and, as will be seen best in the smoothed curve 
graph, the diametrically opposite behaviour of boys and girls at the 
onset of puberty. 

In conclusion: — ■ 

1. As far as my reading goes, I have not found any previous state- 

ment of the curiously abrupt limitation and diametrically 
opposite sex rate of growth at exactly the onset of puberty, nor 
of any precise fixing of the moment of the maximum rate of 
growth ; nor have I found any stress laid on the scientific value 
of rate of growth in anthropometry. 

2. In the analysis of growth statistics little attention has been paid 

either to percentage increments or to percentile frequency 
graphs, both of which give the most valuable and accurate idea 
of rate of growth and so of growth itself. 



69 



Physical Condition of Children attending Public Schools in N.S.W. 

(Report compiled by Mr. F. A. Meciiam, Statistical Officer, Education Department). 

When the School Medical Inspection System of this State was re- 
organised by the Department in 1913, the late Dr. C. Savill Willis, Principal 
Medical Officer, arranged to medically examine every school child in the 
State at least three times in his or her school career. Hand in hand with 
this medical examination provision was made to collect at the same time 
data as to the height and weight of each child examined, and, from the 
particulars so collected, to prepare a set of anthropometric tables that 
might tend to show what is the true position with regard to the physique 
of the growing generation in this State. 

On the completion of the first round of medical inspection (i.e., 
when it was estimated that every school child in the State had been 
examined once), the work of preparing the tables was commenced. It 
has now been completed, and the tables as set out reveal certain 
interesting facts. In all 216,470 children (112,259 boys and 104,211 
girls) have been dealt with. Of this total, 98,597 boys and 88,9 CO girls, 
or a total of 187,557 children, came from State Schools, while the balance 
of 28,913 children were attending Non-State Schools, principally those 
connected with the Roman Catholic denomination. 

The tables have been constructed so as to show the average height 
and weight of children in half-yearly periods ranging from 5 to 16 years 
of age, boys being shown separately from girls. In order to_ ascertain 
whether children living in country districts develop in physique more 
rapidly than those living in the city and crowded suburban areas, a 
classification of the children dealt with has been made into three groups, 
namely :— 

1. Those living in the metropolitan area. 

2. Those living in large country towns. 

3. Those living in the rural districts. 

In addition, a further division into parentage groups has been 
made, and tables have been arranged showing the average height and 
weight of (1) children with both Australian parents ; (2) children with 
parents one Australian and one Foreign; and (3) children with parents 
both Foreign. New Zealand has been included as Australia, while the 
word " Foreign r ' has been applied to a parent of any nationality born 
outside Australia. 

Taking the State Schools separately, and dealing first with the 
height and weight of all boys and girls examined, the following results 
have been obtained : — 

Weight.— The average weight for boys at 5 years of age is 40| lb.:., 
while for girls it is 39| lbs. This advantage in weight is retained by the 
boys, in a slightly greater degree until the age 11| years is reached. 
The girls then become heavier than the boys by a little over three-quarters 
of a pound, the weight at the age being— boys, 69-60 lbs., and girls, 70-42 
lb.3. From 11| to 15^ years the girls increase in weight over the boys 
every half year, the maximum increase being reached at 13| years, 



70 



where girls are shown to be 7-37 lbs. heavier than the boys. At that age 
the average weight of a boy is shown as 83-02 lb?., while for a girl it is 
given as 90-39 lbs. At 14 years of age girls are 5-87 lbs. heavier than boys, 
the weights for that year being — boys, 88-20 lbs., and girls, 94-07 lb\ At 
14| years the girls advantage in weight falls to 4-49 lbs., while a half year 
later, namely, at 15, the average weight of a girl is shown as 102-97 lbs., 
and for a boy 99-79 lbs., or an advantage for the girls of 3-18 lbs. At 15| 
years, when the boys become heavier than the girls, the advantage on the 
side of the boys is only £ lb., but at the age of 16 years a comparison of 
weight shows that boys are 2-04 lbs. heavier than girls. A boy at 16 
weighs 111-17 lbs., and a girl 109-13 lbs. 

The following table will show the average weight of boys and 
girls at each half year of age. It also shows the various periods of age 
at which the advantage in weight is obtained by either boys and girls : — ■ 





Number of Children 












Examined. 


Average 


Weight. 


Advantage 


in Weight. 


Age. 














Boys. 


Girlg. 


Boys. 


Girls. 


Boys over Girls. 


Girls over Boys. 








lbs. 


lbs. 


lbs. 


lbs. 


5 


1,076 


924 


40-48 


39-23 


•23 




5* 


2,580 


2,174 


41-12 


40-42 


•70 




6 


3,993 


3,233 


43-26 


41-94 


1-32 




6£ 


4,973 


4,478 


45-05 


43-95 


1-10 




7 


5,296 


5,205 


47-33 


46-02 


1-31 




7J 


6,019 


5,451 


49-45 


48-25 


1-20 




8 


6,228 


5,614 


51-82 


50-39 


1-43 




8| 


5,717 


5,642 


54-03 


52-74 


1-29 




9 


6,258 


5,392 


56-98 


55-27 


1-71 




9J 


6,011 


5,219 


58-80 


58-21 


•59 




10 


6,014 


5,431 


61-49 


60-73 


•76 




10J 


5.804 


5,153 


63-86 


63-50 


•36 




11 


5,577 


5,027 


66-53 


66-35 


•18 




m 


5,680 


4,715 


69-60 


70-42 




•82 


12 


5,286 


4,556 


72-22 


74-34 




2-12 


m 


5,576 


4,745 


75-70 


79-43 




3-73 


13 


5,059 


4,356 


78-59 


84-59 




6-00 


131 


4,549 


4,077 


83-02 


90-39 




7-37 


14 


2,926 


2,958 


88-20 


94-07 




5-87 


14£ 


1,997 


1,756 


94-03 


98-82 




4-49 


15 


1,011 


1,158 


99-79 


102-97 




3-18 


15* 


503 


692 


106-29 


106-00 


•29 




16 


331 


384 


11117 


109-13 


2-04 





Height. — -As already shown boys are heavier than girls until they 
reach 11| years, and from that age up to 15 girls exceed the boys in 
avoirdupois. With regard to height a somewhat similar position is 
revealed. From 5 to 10^ years girls are shorter than boys, while from 
that age until 15 is reached girls are recorded as taller than boys. At 
the age of 5 years the average height of a boy is 42-05 inches, while for 
a girl it is shown as 41-56 inches. This is an advantage of about half an 
inch for the boys, and the boys retain this advantage until the age of 
7 years is reached. From then on till 10 years the margin is reduced to 
about a quarter of an inch on the side of the boys, while at 11 years the 
average height of both boys and girls is the same, namely, 53-64 inches. 
At \\\ years, where the girls move ahead of the boys, the margin on the 
girls side is -32 of an inch. From then on to 13 the advantage at each 
half year is about three-quarters of an inch, and at 13| years the maximum 
increase is shown, girls being here recorded as slightly over an inch 
taller than boys. This advantage then declines, and at 15 years the 
girls are about a quarter of an inch shorter than boys. At 16 the 
respective heights of boys and girls are 64-24 and 62-27 inches, an 
advantage of almost 2 inches for the boys. 



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71 



Table showing the Heights of Boys and Girls at each half year of age. 



Age. 



Number of Children 
Examined. 



Boys. 



Girls. 



Average Height. 



Boys. 



Girls. 



Advantage in Height. 



Boys over Girls. Girls over Boys. 



5 

64 
6 

64 

7 

7* 

8 

84 
9 

94 
10 

104 
n 

114 

12 

124 

13 

134 

14 

144 
15 
15*. 
16 







Inches. 


Inches. 


1,073 


924 


4205 


41-56 


2,580 


2,174 


42-57 


42.55 


3,393 


3,233 


4407 


43-53 


4,973 


4,478 


44-97 


44-51 


5,296 


5,205 


46-27 


45-63 


6,019 


5,451 


46-90 


46-66 


6,228 


5,614 


48-00 


47-64 


5,717 


5,642 


48-93 


48-68 


6,258 


5,392 


50-07 


49-63 


6,011 


5,219 


50-99 


50-65 


6,014 


5,431 


51-81 


51-59 


5,804 


5,153 


52-70 


52-65 


5,577 


5,027 


53-64 


53-64 


5,680 


4,715 


54-44 


54-76 


5,286 


4,556 


55-19 


55-79 


5,576 


4,745 


56-12 


56-90 


5,059 


4,356 


57-19 


58-15 


4,549 


4,077 


58-14 


59-22 


2,926 


2,958 


59-38 


60-05 


1,997 


1,756 


60-55 


61-00 


1,011 


1,158 


61-79 


61-57 


503 


692 


63-18 


61-92 


331 


384 


64-24 


62-27 



Inch. 



•49 
•02 
•54 
•46 
•64 
•24 
•36 
•25 
•44 
•34 
•22 
•05 



•22 
1-26 
1-97 



Inch. 



•32 
•64 
•78 
•96 
1-08 
•67 
•45 



HEIGHTS AND WEIGHTS OF CHILDREN RESIDING IN METROPOLITAN 
AND COUNTRY DISTRICTS. 

The investigation into the anthropometric condition of children 
residing in country and metropolitan districts furnishes conclusive 
evidence that the fresh air and free life of the country child assists 
materially in the building of children of the largest physique. This fact 
is very strikingly emphasised when the tables are examined, for it is 
there shown that boys and girls residing in country districts are both 
heavier and taller than children reared in the city and crowded suburban 
areas. More forcibly is this fact brought home when it is revealed that 
children living in rural districts, while of bigger physique than metro- 
politan children, are at the same time bigger all round than children 
assembled in large country towns. The following details are of interest :■ — ■ 
At 5 years of age a boy in the metropolitan area weighs on an average 
39-90 lbs., in large country towns 40*48 lbs., and in rural districts 
41*60 lbs. This shows that the boy in the rural districts is nearly If lb. 
heavier than the metropolitan boy, while the large country town boy 
is slightly over | lb. heavier than the city lad. From 5 years until the 
•age of 9 years is reached the advantage in weight of the rural boy over 
the city boy varies at each half year of age from 1| to If lb. From 9 
to 14| years of age the margin of advantage each half year fluctuates 
from 2 to Z\ lb?., the maximum being reached at 12 years, where the 
rural boy is shown to be 3-59 lbs. heavier than the city lad. At 15 the 
rural boy is smaller in physique than both the city and large country- 
town boy, and at 16 the large country town boy is bigger than the 
city lad, the rural boy being the smallest. Too much reliance cannot, 
however, be placed on the accuracy of the figures at these latter years, 
inasmuch as the number of boys examined at 15 and 16 is very small 
when compared with those dealt with at other years. For instance, 
in the Metropolitan area only 200 boys at 16 years were measured, 
while in most of the other years 2,000 and over were dealt with. 
Taking the age of 14 years as the terminal point the weights of boys 



72 



in the various groups are :— Metropolitan, 86-70 lb .; large country towns, 
89-96 lbs.; and rural districts, 89-72 lbs. An advantage of a small 
fraction of a pound is, therefore, shown for the large town boy, but 
this appears to be the point where the rural boy loses ground, possibly, as 
before stated, on account of the decline in the number dealt with. 

The following table gives in detail the average weights of boys 
in country and metropolitan districts, and at the same time shows the 
advantage in weight obtained by the rural boy over the city boy, &c. : — 





No. 


of Boys Examined. 


Average Weight. 


Advantage in Weight. 


Age. 




Largo 






Large 




Rural 


Large Town 


Rural Boys 




Metro- 


Country 


Rural 


Metro- 


Country 


Rural 


Boys over 


Boys over 


over Large 




politan. 


Towns. 


Districts. 


politan. 


Town?. 


Districts. 


Metropolitan 


Metropolitan 


Country 
















Boys. 


Boys. 


Town Boys. 










lbs. 


lis. 


lbs. 


lbs. 


lbs. 


Ibe. 


5 


505 


2S9 


282 


39-90 


40-48 


41-60 


+ 1-70 


+ 58 


+ 1-12 


5J 


1,212 


700 


668 


40-93 


41-41 


41-20 


+ "27 


+ -48 


— -21 


G 


1,505 


877 


1,011 


42-59 


43-29 


44-21 


+ 1-62 


+ -70 


+ -92 


6| 


1,939 


1,273 


1,761 


44-41 


45-11 


45-71 


+ 1-30 


+ -70 


+ -60 


7 


2,187 


1,515 


1,594 


4G-10 


47-00 


4S-00 


+ 1-90 


+ -90 


+ 1-00 


n 


2,306 


1,516 


2,197 


48-77 


49-29 


50-27 


+ 1-50 


+ -52 


+ -98 


8 


2,457 


1,728 


2,043 


50-94 


51-8S 


52 '88 


+ 1-94 


+ -94 


+ 1-00 


8£ 


2,358 


1,298 


2,061 


53-22 


53-95 


54-95 


+ 1-73 


+ -73 


+ 1-00 


9 


2,366 


1,851 


2,041 


55-92 


57-46 


57-72 


+ 1-80 


+ 1-54 


+ -26 


n 


2,234 


1,584 


2,193 


57-77 


58-85 


59-85 


+ 2-08 


+ 1-08 


+ 1-00 


10 


2,194 


1,660 


2,160 


60-01 


61-42 


63-00 


+2-99 


+ 1-41 


+ 1-58 


10| 


2,222 


1,538 


2,044 


62-99 


62-91 


65-52 


+ 2-53 


— -08 


+2-61 


11 


2,232 


1,475 


1,870 


65-73 


66-61 


67-44 


+ 1-71 


+ -88 


+ -83 


11J 


2,101 


1,417 


2,162 


68-80 


68-77 


70-93 


+213 


— -03 


+ 2-16 


12 


2,071 


1,319 


1,896 


70-73 


71-35 


74-32 


+3-59 


+ -62 


+2-97 


12J 


2,128 


1,311 


2,137 


74-10 


7513 


77-67 


+ 3-57 


+ 1-03 


+ 2-54 


13 


2,043 


1,393 


1,623 


77-87 


78-16 


79-90 


+2-03 


+ -29 


+ 1-74 


13J 


1,657 


1,238 


1,664 


81-76 


82-55 


84-70 


+2-94 


+ -79 


+2-15 


14 i 


1,478 


548 


900 


86-70 


89-96 


89-72 


+3-02 


+3-26 


— -24 


l*i 


767 


789 


441 


93-66 


9204 


95-77 


+2-11 


—1-62 


+ 3-73 


15 


537 


306 


168 


99-69 


100-09 


99-55 


— -14 1 


— -40 


— -54 


15J 


274 


142 


87 


108-80 1 


103-96 


102-22 


—6-58 


—4-84 


—1-74 


16 


200 


73 


58 


111-46 


112-93 


109-64 


—1-82 

; 


+ 1-47 


—3-29 



With regard to height a similar position to weight is revealed in 
favour of the lad of the rural districts. From the age of 5 years until 
he reaches 14 he is shown to be considerably laller than the city boy. 
He is also taller than the boy in the large country towns, but not to such 
a marked degree. At 5 years of age the respective heights for boys are: — 
Metropolitan, 41-87 inches; large country towns, 42-10 inches; and 
rural districts, 42-30 inches. At that age the rural boy is, therefore, -43, 
or nearly half an inch, taller than the city boy, while at the same time he 
exceeds the large country town boy by -20 of an inch. From 5 years up 
to 12 years the rural lad retains his advantage over the city boy by an 
average of about three-quarters of an inch at each half year of age. 
At 13 he is 1-10 inch taller than the city boy, and at 14 he increases this 
margin to 1-29 inch. At 15 and 16 the rural boy is shorter than the 
city boy, but here again the result is somewhat interfered with on account 
of the small number dealt with. At 14 the average heights of boys in 
the three groups are given as :— Metropolitan, 59-01 inches ; large country 
towns, 59-30 inches; and rural districts, 60-30 inches. 

With regard to the boys living in large country towns, although 
they may be said to be taller than the city boys, their advantage is not 
so pronounced. For instance, from 5 to 7 years of age the margin in 
each half year varies from -18 to -57 of an inch. From then on the margin 
fluctuates to such a degree that it might almost be said that from 7 to 14 
years the large town boy has little or no advantage over the city boy^ 



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73 



Age. 



5 

6 

0* 

7 

8 

8.i 

9 

n 

10 

10J 

11 

11J 

12 

\2\ 

13 

13J 

14 

15 

15J 

16 



The table given hereunder will show clearly the advantage in height 
of the country children over those residing in the metropolitan area : — 



No. of Boys Examined. 



Metro- 
politan. 



Large 
Country 
Towns. 



Rural 
Districts. 



505 
1,212 
1,505 
1,939 
2,187 
2,306 
2,457 
2,358 
2,366 
2,234 
2,194 
2,222 
2,232 
2,101 
2,071 
2,128 
2,043 
1,657 
1,478 
767 
537 
274 
200 



Average Height. 



Metro- 
politan. 



T.arge 
Country 
Towns. 



289 

700 

877 

1,273 

1,515 

1,516 

1,728 

1,298 

1,851 

1,584 

1,660 

1,538 

1,475 

1,417 

1,319 

1,311 

1,393 

1,238 

548 

789 

306 

142 

73 





inches. 


282 


41-87 


668 


42-17 


1,011 


43-64 


1,761 


44-69 


1,594 


45-54 


2,197 


46-78 


2,043 


47-74 


2,061 


48-69 - 


2,041 


49-72 


2,193 


50-07 


2,160 


51-27 


2,044 


52-41 


1,870 


53-44 


2,162 


54-17 


1,896 


54-92 


2,137 


55-62 


1,623 


56-83 


1,664 


57-86 


900 


59-01 


441 


60-94 


168 


61-70 


87 


63-44 


58 


64-37 



inches. 
42-10 
42-74 
44-14 
44-87 
45-81 
47-27 
47-79 
48-49 
50-04 
50-80 
51-73 
52-03 
53-49 
54-04 
54-74 
55-88 
56-86 
57-87 
59-30 
59-91 
61-95 
62-80 
64-07 



Rural 
Districts. 



Advantage in Height. 



Rural 

Boys over 

Metropolitan 

Boys. 



inches. 
42-30 
42-50 
44-05 
45-41 
40-41 
47-05 

' 48-51 
49-48 
50-57 
51-46 
52-44 
53-30 
54-01 
54-88 
55-79 
56-77 
57-93 
58-55 
60-30 
61-02 
61-69 
63-08 
64-04 



inches. 
+ -43 
+ -33 
+ 1-01 
+ -72 
+ -87 
+ -27 
+ -77 
+ -79 
+ -85 
+ -79 
+ 1-17 
+ -89 
+ -57 
+ -71 
+ -87 
+ 1-15 
+ 1-10 
+ -69 
+ 1-29 
+ -08 

— -01 

— -32 

— -33 



Large Town 


Boys 


over 


Metropolitan 


Boys. 


inc 


les. 


+ 


•23 


+ 


•57 


+ 


•50 


+ 


•18 


+ 


•27 


+ 


■49 


+ 


•0'» 


— 


•20 


+ 


•32 


+ 


■13 


+ 


■46 


— 


•38 


+ 


•05 


— 


•13 


— 


•18 


+ 


•26 


+ 


•03 


+ 


•01 



+ -29 
—1-03 

— -25 

— -64 

— -30 



Rural Boys 

over Large 

Country 

Town Boys. 



inches. 
+ -20 

— -24 
+ -50 
+" -54 
+ -60 

— -22 
+ -72 
+ -99 
+ -43 
+ : 66 
+ -71 
+ 1-27 
+ -52. 
+ -84 
+ 1-05 
+ -89 
+ 1-07 
+ -'68 
+ 1-00 
+ 111 

— -26 
+ -28 

— -03 



Girls. — In analysing the tables dealing with girls it is found that 
the rural girl is heavier at all ages than the metropolitan and large country 
town girl. At 5 years of age the rural girl is shown to be 1-91 lb. heavier 
than the metropolitan girl, the average weight for the three groups at 
5 years being as follows : — Metropolitan, 38-54 lb. ; large country towns, 
39-90 lb. ; and rural districts, 40-45 lb. From 5 years until 9| years is 
reached the advantage in weight is retained, the margin at each half 
year of age in favour of the rural girl being about 1| lb. At 10 years she 
is 2§ lb. heavier than the metropolitan girl; at 11 years, 3 lb. heavier; 
while at 12| years she increases her advantage to a maximum of 4 lb. 
At 14 years the average weights recorded are : — Metropolitan girls, 
93-74 lb.; large country town girls, 92-60 lb.; and rural girls, 95-38 lb. 
It will thus be seen that the rural girl at 14 is 1-64 lb. heavier than the 
metropolitan girl, and at the same time she exceeds the large country 
town girl by 2| lb. At this age the large country town girl is shown 
to be lightest, but possibly this is accounted for by the fact that only 
716 large country town girls were weighed, while both in the metropolitan 
and the rural districts 1,100 girls were dealt with. 

A comparison of the weights of large country town and metro- 
politan girls shows that the large country town girl from 5 to 12| years 
is the heavier, but not to such a marked degree as the rural girl. For 
instance, at 5 and 6 years of age she is heavier than the city girl by 
1-36 lb. and 1-23 lb. respectively, but from then on to the age of 12 
years her advantage at each half year of age fluctuates from \ lb. to 
1 lb. At 12| years she weighs 2 - 38 lb. more than the metropolitan girl, 
but from that age until she reaches 15-| }~ears she is recorded as 
being much lighter. At 16, however, she is shown to be heavier by 
1-16 lb., the average weight for that year being: — Metropolitan girls, 
106-84 lb.; large country town girls, 108 lb.; and rural girls, 112-12 lb. 
In considering this result due regard must be paid to the fact that 



n 



considerably less girls were weighed in large country towns than in the 
metropolitan and rural districts, the numbers being : — Metropolitan, 
34-111; large country towns, 22,460; and rural districts, 31-768. The 
difference, therefore, ranges from 9,000 to 12,000, and possibly such 
difference has had a detrimental effect on the result. 

Particulars as to the weights of girls in country and metropolitan 
districts are given in the table overleaf : — 



eV 


No. 


of Girl9 Examined. 


Average Weight. 


Advantage in Weight. 


;Age. 


Metro- 


Large 
Country 


Rural 


Metro- 


Large 
Country 


Rural 


Rural 
Girls over 


Large 
Country Towns 

I^J-irla ftvpr 


Rural Girls 
over Large 


s: 


politan. 


Towns. 


Districts. 


politan. 


Towns. 


Districts. 


Metropolitan 
Girls. 


Metropolian 
Girls. 


Country 
Town Girls. 


. . 








lb. 


lb. 


lb. 


lb. 


lb. 


lb. 


5 


398 


272 


254 


38-54 


39-90 


40-45 


+ 1-91 


+ 1-36 


+ -55 


5* 


984 


521 


669 


39-90 


40-17 


41-36 


+ 1-46 


+ -27 


+ 1-19 


6 


1,266 


938 


1,029 


41-07 


42-30 


42-68 


+ 1-61 


+ 1-23 


+ -38 


6* 


1,720 


1,248 


1,510 


43-30 


43-87 


44-93 


+ 1-63 


+ -57 


+ 1-06 


7 


2,117 


1,358 


1,730 


45-36 


46-31 


46-62 


+ 1-26 


+ -95 


+ 31 


n 


2,020 


1,489 


1,942 


47-99 


47-77 


48-89 


+ -90 


— -22 


+ 1-12 


8 


2,162 


1,477 


1,975 


49-74 


49-93 


51-45 


+ 1-71 


+ -19 


+ 1-52 


8* 


2,189 


1,363 


2,090 


51-90 


53-05 


53-44 


+ 1-54 


+ 1-15 


+ -39 


9 


2,038 


1,416 


1,938 


54-55 


5513 


56-12 


+ 1-57 


+ -58 


+ -99 


9* 


2,010 


1,167 


2,042 


57-50 


58-34 


58-86 


+ 1-36 


+ -84 


+ -52 


10 


2,105 


1,438 


1,888 


59-79 


60-42 


62-55 


+2-76 


+ -63 


+ 213 


m 


1,997 


1,296 


1,860 


62-49 


63-23 


64-78 


+2-29 


+ -74 


+ 1-55 


ii 


1,960 


1,321 


1,746 


65-30 


65-23 


68-37 


+3-07 


— -07 


+3-14 


li* 


1,597 


1,255 


1,863 


69-59 


70-59 


71-02 


+ 1-43 


+ 1-00 


+ -43 


12 


1,788 


1,034 


1,734 


7311 


73-70 


76-01 


+ 2-90 


+ -59 


+ 2-31 


12* 


1,880 


1,105 


1,760 


77-39 


. 79-77 


81-39 


+4-00 


+ 2-38 


+ 1-62 


13 


1,659 


1,152 


1,544 


83-63 


83-53 


86-44 


+ 2-81 


— -10 


+2-91 


13* 


1,483 


1,068 


1,526 


89-75 


88-46 


90-11 


+ -36 


—1-29 


+ 1-65 


14 


1,142 


716 


1,100 


93-74 


92-60 


95-38 


+ 1-64 


—114 


+ 2-78 


14* 


658 


376 


722 


98-28 


97-34 


99-82 


+ 1-54 


— -94 


+2-48 


15 


502 


215 


441 


103-10 


100-73 


103-92 


+ -82 


—2-37 


+3-19 


15* 


267 


154 


271 


106-04 


103-30 


107-50 


+ 1-46 


—2-74 


+4-20 


16 


169 


81 


134 


106-84 


108-00 


112-12 


+5-28 


+ 1-16 


+ 2-12 



Height. — In height, as well as weight, the rural girl has the 
advantage over the metropolitan and large country town girls at all 
ages from 5 to 16 years. At 5 years she is recorded as being lj inch 
taller than the metropolitan girl, and 1 inch taller than the large country 
town girl, the average heights for the three groups at that particular age 
being : — Metropolitan girls, 40-95 inches; large country town girls, 41-53 
inches, and rural district girls, 42-54 inches. As the girls advance in age 
however, this advantage declines, but at the same time a somewhat 
uniform margin is shown. For instance, from 5| to 10§ years the 
advantage is decidedly in favour of the rural girl, for between those 
years she is recorded as being from J to § inch taller than the metropolitan 
girl at each half year of age. At 11 years she is slightly over an inch 
taller, while 18 months later, namely at 12| years, it is shown that she 
is 1-13 inch taller than the metropolitan girl. At 14 years of age the 
average height recorded for the three groups is : — Metropolitan girls, 59-73 
inches; large country towns girls, 59-81 inches; and rural district girls' 
60-53 inches. At this age the advantage in favour of the rural girl is, 
therefore, slightly over f inch, while at 16 years of age practically the 
same margin is shown. 

A comparison of the heights of large country town and metro- 
politan girls shows that at certain ages the large town girl is the taller, but 
not to a very great extent. As a matter of fact there is such a fluctuation 
of heights between these two groups that it might easily be said that one 
has little or no advantage over the other. For instance, at 5 and 6 years 
of age the large town girl is recorded as slightly over J inch taller than 



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75 



the metropolitan girl. At 6| years, however, they are shown to be the 
same height, namely, 44-29 inches, while 2 years later, namely, at 9 years, 
the metropolitan girl is shown to be the taller by '12 of an inch. At 10 and 
11 years they are practically the same height, while at 14 years of age 
the large town girl is shown to have the advantage by -08 of an inch 
From 14 to 16 the margin is in favour of the metropolitan girl. Ill 
dealing with the heights it was pointed out that the number of large 
town girls weighed was considerably less than metropolitan and rural 
girls, and that possibly the difference — ranging from 9 to 12,000— 
had an effect on the result. The same remarks might be applied when 
considering the result arrived at with regard to heights. 

The following table will show clearly the difference in heights 
between country and metropolitan girls. 





No. 


of Girls Examined. 


Average Height. 


Advantage in Height. 


Age. 


Metro- 


Large 
Country 


Rural 


Metro- 


Large 
Country 


Rural 


-Rural 
Girls over 


Large 
Country Town 

Girls over 

Metropolitan 

Girls. 


Rural Girls 
over Large 




politan. 


Towns. 


Districts. 


politan. 


Towns. 


Districts. 


Metropolitan 
Girls. 


Country 
Town Girls. 










inches;. 


inches. 


inches. 


inches. 


inches. 


inches. 


5 


398 


272 


254 


40-95 


41-53 


42-54 


+ 1-59 


+ -58 


+ 1-01 


H 


984 


521 


669 


42-45 ■ 


42-10 


43-08 


+ -63 


— -35 


+ -98 


6 


1,266 


938 


1,029 


43-12 ■ 


43-67 


43-91 


+ -79 


+ -55 


+ -24 


H 


1,720 


1,248 


1,510 


44-29 


44-29 


44-75 


+ -46 




+ -46 


7 


2,117 


1,358 


1,730 


45-38 : 


45-58 


45-98 


+ -50 


+ -20 


+ -30 


n 


2,020 


1,489 


1,942 


46-45 


46-51 


47-00 


+ -55 


+ -06 


+ -49 


8 


2,162 


1,477 


1,975 


47-29 


47-56 


48-10 


+ -81 


+ -27 


+ -54 


84 


2,189 


1,363 


2,090 


48-41 


48-52 


49-07 


+ -66 


+ -11 


+ -55 


9 


2,038 


1,416 


1,938 


49-40 


49-28 


5014 


+ -74 


— -12 


+ -86 


9* 


2,010 


1,167 


2,042 


50-40 


50-54 


50-96 


+ -56 


+ -14 


4- -42 


10 


2,105 


1,438 


1,888 


51-28 


51-29 


52-17 


+ -89 


+ -01 


+ -88 


10J 


1,997 


1,296 


1,860 


52-35 


52-34 


53-20 


+ -85 


— -01 


+ -86 


11 


1,960 


1,321 


1,746 


53-26 


53-28 


54-35 


+ 1-09 


+ -02 


+ 1-07 


m 


1,597 


1,255 


1,863 


54-43 ' 


"54-67 


55-10 


+ -67 


+ -24 


+ -43 


12 


1,788 


1,034 


1,734 


55-53 


55-21 


56-42 


+ -89 


— -32 


+ 1-21 


124 


1,880 


1,105 


1,760 


56-43 


56-64 


57-56 


+ 113 


+ -21 


+ -92 


13 


1,659 


1,152 


1,544 


57-94 i ■ 


\ 57-68 


58-74 


+ -80 


— -26 


+ 1-06 


13J 


1,483 


- 1,068 


1,526 


58-81 


. - 59-03 


59-75 


+ -94 • 


+ -22 


+ -72 


14 


1,142 


716 


1,100 


59-73 


59-81 


60-53 


+ -80 


+ -08 


+ -72 


1H 


658 


376 


722 


60-85 


60-82 


61-21 


+ -36 


— -03 


+ -39 


15 


502 


215 


441 


61-47 


61-16 


61-87 


+ -40 


— -31 


+ -71 


154 


267 


154 


271 


61-68 


61-60 


62-35 


+ -67 


— -08 


+ -75 


16 


169 


81 


134 


62-02 


- 61-86 


62-85 


+ -83 


— -16 


-f -99 



PARENTAGE GROUPS. 

In considering the result obtained by the classification of children 
into Parentage Groups, it would be well to point out that there is a very 
vast difference between the number of children treated with under the 
three specified groups, and that consequently the basis for comparison 
has been very seriously affected by the inequality of the numbers. This 
will be readily seen when it is shown that out of a total of 98,577 boys 
weighed and measured in State Schools, it has only been possible to place 
13,036 under the heading " Parents both Foreign" ; 17,162 under " One 
Australian, One Foreign" ; while the balance of 63,568 are recorded 
as having parents " Both Australian." Nearly 5,000 it was impossible 
to classify, inasmuch as no particulars as to nationality of parents were 
furnished. 

Taking the tables as they stand, and dealing first with the boys, 
it is clearly shown that boys of both Australian parents are the biggest 
in physique. The following tables will show the details, and from them 
it will be noticed that the advantage in both height and weight in favour 
of the boys with Australian parents is very pronounced, more particularly 
when a comparison is made with the boys with parents " Both Foreign." 



Boys of Australian parentage when compared with the latter group are 
both heavier and taller at all ages, the advantage in weight in the middle 
years extending from 1 to 2 lb., while in height the margin is about | inch. 
Boys with parents " One Australian and One Foreign "' are smaller than 
boys with Australian parents, but the margin of deficiency is not so 
great as in the case of boys with parents " Both Foreign." 





Average Weight. 


Advantage 


in Weight. 


Age. 




Boys with Parents. 




Both 


Both 








Australian 


Australian 










over one 


over both 




Both 
Australian. 


Australian, 
one Foreign. 


Both 
Foreign. 


Australian 
one Foreign. 


Foreign. 




lb. 


lb. 


lb. 


lb. 


lb. 


5 


40-49 


40-54 


40-22 


— -05 


+ -27 


5| 


41-27 


41-11 


40-43 


+ -10 


+ -84 


6 


43-36 


43-42 


42-56 


— -06 


+ -80 


Ci 


45-76 


44-77 


44-34 


+ -99 


+ 1-42 


7 


4711 


46-12 


46-97 


+ -99 


+ -24 


7J 


49-61 


49- 10 


4915 


+ -51 


+ -46 


8 


52-04 


51-53 


51-25 


-f -51 


+ -79 


§4 


54-22 


54-14 


52-83 


+ -08 


+ 1-49 


9 


5-38 


56-38 


55-75 


+ 1-00 


+ 1-63 


n 


5918 


58-86 


57-53 


+ -32 


+ 1-65 


10 


61-77 


61-31 


60-57 


+ -46 


+ 1-20 


104 


64-08 


63-83 


63-05 


+ -25 


+ 1-03 


11 


66-94 


66-16 


65-57 


+ -78 


+ 1-37 


"4 


69-50 


69-41 


68-24 


+ -09 


+ 1-26 


12 


72-39 


72-27 


71-63 


+ -12 


+ -76 


124 


76-14 


75-44 


74-38 


+ -70 


+ 1-76 


13 


78-90 


78-60 


77-89 


+ -30 


+ 1-01 


13J 
14 


83-54 
88-66 


83-54 
86-97 


81-53 
87-03 




+ 2-01 


+ 1-79 


+ 1-63 


144 


93-98 


93-52 


93-38 


+ -46 


+ -60 


15 


100-05 


98-52 


99-56 


+ 1-53 


+ -49 


154 


106-07 


106-56 


105-54 


— -49 


+ -53 


16 


112-63 


112-32 


108-11 


+ -31 


+ 4-52 





Boys. — Tabic shov 


zing Particulars 


as to Height. 






Average Height. 


Advantage 


in rielght. 


Age. 




Boys with Parents. 




Both 
Australian 


Both 
Australian 
over both 
Foreign. 




Both 


One 
Australian, 


Both * 


over one 
Australian 




Australian. 


One Foreign. 


Foreign. 


one Foreign. 




inches. 


inches. 


inches. 


inches. 


inches. 


5 


42-15 


42-19 


41-23 


— -04 


+ -92 


S4 


42-70 


42-20 


42-35 


+ -50 


+ -35 


6 


4406 


44-22 


43-77 


— -16 


+ -29 


64 


45-09 


44-87 


44-53 


+ -22 


+ -56 


7 


45-95 


45-60 


45-83 


+ -35 


+ -12 


74 


46-91 


46-95 


40-80 


— -04 


+ -11 


8 


48-11 


47-99 


47-54 


+ -12 


+ -57 


84 


49-00 


49-01 


48-97 


— -01 


+ -03 


9 


50-18 


50-07 


49-71 


+ -11 


+ -47 


94 


5113 


50-91 


50-48 


+ -22 


+ -65 


10 


51-91 


51-78 


51-51 


+ -13 


+ -40 


104 


52-84 


52-70 


52-33 


+ -14 


+ -51 


n 


53-84 


53-54 


5302 


+ -30 


+ -82 


114 


54-44 


54-39 


53-84 


+ -05 


+ -60 


12 


55-23 


55-22 


5502 


+ -01 


+ -21 


12* 


56-22 


5614 


55-69 


+ -08 


+ -53 


13 


57-39 


57-12 


56-68 


+ -27 


+ -71 


134 


58-23 


58-74 


57-79 


— -51 


+ -44 


14 


59-50 


59-39 


59-16 


+ -11 


+ -34 


144 


60-64 


60-61 


60-28 


+ -03 


+ -36 


15 


61-79 


. 61-65 


61-32 


+ -14 


+ -47 


154 


■ 6316 


63-38 


63-18 


— -22 


— -02 


16 


64-54 


64-08 


63-50 


— -46 


1 -04 



Girls. — In dealing with the girls the difference in numbers must 
also be considered when reviewing the result obtained. In State Schools, 
88,960 girls were weighed and measured. Of this total, 57,207 are 
recorded as having " Australian Parents," while only just over 15,000 
and 1 1,000 respectively were classified under the heading " One Australian, 



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RATE of GROWTH 

Height (lower), Weight (upper), Boys (red), Gsrls (blue). 

PERCENTAGE INCREMENTS. 

AgE:YeARS^HaLfYeARS:- 5 Years &9 Months to 6YEARs&2MoNTHS=6,8YEARS&3MoNTHSTo6YEARS&8MoNTHS=6y2 
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PROPORTIONATE DISTRIBUTION IN EACH AGE GROUP ACCORDING TO HEIGHT IN INCHES 
SYDNEY BOYS-BLUE. COMMONWEALTH CADETS-RED. 




« 50 

Height in Inches. 

. , D1 . p rtionate distribution of -02. The figures printed at the base indicate height in inches, while those 

The base of each s ma ll rectangle represents two inches, wh.le the verfcle he.ght represents a j»op ^^ ^ ^ ^ ^ ^ ^ ^ ^ 

along the curves give the central ago of each age group. 



•MOTC-L'THOQBAfHE ev *■ 



II LICK, COVIRNMCHT I 



3HT IN INCHES 




88 40 

Height in Inches. 



60 



62 



64 



66 



The base of each smatyte height in inches, while those at the point of each curve give the central age 
epresented in this graph. 



PROPORTIONATE DISTRIBUTION IN EACH AGE GROUP ACCORDING TO HEIGHT IN INCHES 
SYDNEY GIRLS— SEVE. COMMONWEALTH CADETS (BOYS)— 1 





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Tbe base of each small rectangle represents two inches, while the vertical height represents a proportionate distribution of 02. The figures printed at the base indicate height in inches, while those at the point of each Curve give the central n-jfe 

of each age group. A sex comparison between Commonwealth Cadet Boys and Sydney Metropolitan Girls is represented in this graph. 



77 



One Foreign," and " Both Foreign." This difference must naturally 
have some bearing on the result, and it would be perhaps dangerous to 
say that the figures quoted hereunder furnish a true statement regarding 
the physique of children with Australian parents, and those of other 
nationalities. However, the investigation made shows that, as well as 
boys, girls of Australian parentage arc bigger all round than the children 
classified under the other two groups. At most ages they weigh more, 
the advantage fluctuating, from £ to 2\ lb., while with regard to height 
they are shown to be taller, in somes cases the difference being \ inch and 
over. 

The following tables will show in full the details of advantage. 
Girls. — Tabic showing Particulars as to Weight. 





Average Weight. Advantage in Weight. 


Age. 


Girls with raronts. . 


Bo h 

Australian 


roth 




Both 
Australian. 


One 
Australian, 
one Foreign. 


Both 
Foreign. 


over one 

Australian 

one Foreign. 


over both 
Foreign. 


5 
54 

6 
6i 

7 

8 

8| 

9 

10 

104 

11 

Hi 

12 

124 

13 

134 
14 

144 
15 

154 
16 


lb. 
39-50 
40-55 
41-96 
44-06 
46-17 
48-38 
50-56 
53-00 
55-54 
58-41 
60-89 
63-97 
66-34 
70-25 
74-37 
80-25 
85-36 
90-90 
94-34 
99-26 
102-94 
106-33 
108-85 


lb. 
39-08 
40-29 
41-94 
44-02 
45-55 
47-92 
50-43 
52-21 
55-09 
57-84 
60-31 
62-81 
66-48 
71-22 
74-65 
78-06 
84-37 
89-62 
92-80 
97-72 - 
103-18 
104-81 
106-93 


lb. 
38-27 
39-93 
41-95 
43-82 
45-66 
48-00 
49-81 
52-02 
54-14 
57-94 
60-30 
62-30 
65-69 
70-41 
7409 
78-00 
81-92 
86-77 
92-31 
97-59 
103-03 
105- 12 
113-39 


lb. 
+ -42 
+ -26 
+ -02 
+ -04 
+ -62 
+ -46 
+ -13 
+ -79 
+ -43 
+ -57 
+ -58 
+ -16 

— -14 

— -97 

— -28 
+ 2-19 
+ -99 
+ 1-38 
+ 1-54 
+ 1-54 

— -24 
+ 1-52 
+ 1-92 


lb. 
+ 1-33 
+ -62 
+ -01 
+ -24 
+ -51 
+ -38 
+ -77 
+ -98 
+ 1-40 
+ -47 
+ -59 
+ -67 
+ -65 

— -16 
+ -28 
+ 2-25 
+ 2-45 
+ 413 
+ 2-03 
+ 1-67 

— -09 
+ 1-21 

— 4-44 



Girls. — Table showing Particulars as to Height. 







Average Height. 




Advantage 


ii Height. 


Age. 




Girls with Tarents. 




Both 
Australian 


Toth 




Both 
Australian. 


One 
Australian, 
one Foreign. 


Both 
Foreign. 


over one 

Australian 

one Foreign. 


over both 
Foreign. 




inches. 


inches. 


inches. 


inche3. 


inchee. 


5 


41-81 


41-59 


41-07 


+ -22 


+ -74 


5i 


42-66 


42-35 


42-16 


+ -21 


+ -50 


6 


43-56 


43-54 


43-31 


+ -02 


+ -25 


64 


44-54 


44-42 


44-42 


+ -12 


+ -12 


7 


45-77 


45-55 


45-33 


+ -22 


+ -44 


74 


46-72 


47-41 


46-44 


+ 31 


+ -28 


8 


47-68 


47-72 


47-41 


+ -04 


+ -27 


84 


48-75 


48-63 


48-28 


+ -12 


+ -47 


9 


49-73 


49-53 


49-30 


+ -20 


+ -43 


9| 


50-70 


50-57 


50-51 


+ -13 


+ -19 


10 


51-72 


51-45 


51-29 


+ -27 


+ -43 


104 


52-79 


52-64 


52-11 


+ -15 


+ -68 


11 


53-71 


53-61 


53-25 


+ -10 


+ -46 


114 


54-76 


54-84 


54-75 


— -03 


+ -01 


12 


55-91 


55-75 


55-41 


-f •'..'*. 


+ -50 


124 


57-00 


56-81 


56-58 


+ -19 


+ -42 


13 


58-23 


58-09 


57-62 


+ -14 


+ -61 


134 


59-46 


58-85 


58-77 


+ -61 


+ -69 


14 


60-20 


59-79 


59-79 


+ -41 


+ -41 


144 


6105 


61-08 


60-61 


— -03 


+ -44 


15 


61-60 


61-71 ' 


61-30 


— 11 


+ -30 


15J 


62-08 


61-90 


61-52 


+ -18 


+ -53 . 


16 


62-38 


62-05 


62-44 


+ -33 


— -04 



78 



y i.j 



CHILDREN ATTENDING NON-STATE SCHOOLS. 



As before stated, 28,913 children attending non-State Schools 
were included in the Anthropometric investigation carried out by the 
Medical Branch. Of this total 13,697 were boys and 15,216 girls, and 
the following tables will show the relative positions of heights and weights 
of these boys and girls :— 

Table showing Weights and other Particulars of Boys and Girls attending 

Non-State Schools. 



Age. 


Average 


Weights. 


Advantage in Weight. 












Boys. 


Girls. 


Boys over Girls. 


Girls over Boys. 




lb. 


lb. 


- lb. 


lb. 


5 


40-62 


3S-97 


1-65 




H 


42-93 


41-03 


1-90 




6 


44-11 


42-71 


1-40 




6J 


45-87 


44-72 


1-15 




7 


47-80 


46-47 


1-33 




74 


49-66 


47-47 


2-19 




8 


52-37 


48-22 


4-15 




8* 


54-14 


51-85 


2-29 





9 


56-91 


54-57 


2 34 




94 


58-77 


57-47 


1-30 




10 


61-46 


60-92 


« i -54 




104 


63-73 


62-97 


-•76 




n 


66-68 


67-00 




•32 


114 


69-41 


70-50 


...... 


119 


12 


72-73 


74-01 




1-28 


124 


75-13 


78-58 




3-45 


13 


80-36 


84-04 




3-68 


134 


82-80 


88-70 




5-90 


14 


87-63 


93-78 


■«-....'. 


6-15 


H4 


90-76 


99-38 


...... 


8-62 


15 


94-96 


103-74 


...... 


8-78 


154 


102-79 


106-12 




3-33 


16 


111-32 


112-81 




1-49 



Table showing Particulars as to Heights of Boys and Girls attending 

Non-State Schools. 



Age. 


Average Height. 


"Advantage in Height. 


Boys. 


Girls. 


Boy.;. 


Girls. 


5 

64 
6 

64 
7 

74 
8 

84 
9 

94 
10 

104 

n 

114 

12 

124 

13 

134 

14 

144 
15 
154 
16 


inches. 
42-41 
43-00 
4409 
45-08 
45-88 
47-14 
48-01 
48-78 
50-02 
50-90 
51-26 
52-81 
53-52 
54-54 
55-50 
56-16 
57-83 
58-15 
5906 
59-95 
61-51 
6304 
64-90 


inches. 
41-27 
42-62 
43-66 
44-96. . , , 
45-69L ! 
46-66 
47-30 
48-70-' ' 
49-79" •' 
50-70' ' ' 
51-75 
52-66 
53-80 
54-78 
55-73 
56-96 
58-26 
59-21 
60-20 
61.23 
61-24 
61-89 
62-74 


inches'. 
114 
•38 
•43 
•12 
•19 
•48 
•71 
•08 
•23 
•20 

•15 

•27 
115 
216 


inches. 

"49 

•28 

•24 

•23 

•80 

•43 

116 

1-14 

1-28 



An examination of the foregoing tables reveals almost a similar 
position to that found when dealing with boys and girls attending Stat e 
Schools. In State S chools it has been shown that boys have the advantage 
in weight over girls until they reach the age of 11 -years. In non-State 



79 

Schools, however, the advantage is lost by the boys six months earlier, 
namely, at 10J years. Again, in State Schools boys are heavier than 
girls from 11| years, and they retain the advantage until 15 years. At 
15| and 16 girls are shown to be heavier than boys. At non-State 
Schools girls become heavier at 11 years, and remain in the foreground 
right up to the age of 16 years. „ 

Dealing with weight at each half year of age a somewhat peculiar 
fluctuation is found. Non-State School boys from the age of 5 until 
they reach 9 years are shown to be the heaviest, while from 9| to 1 6 years 
the position is reversed. With regard to girls the fluctuation is back- 
ward and forward' to such an extent that neither side can claim the 
advantage. The following table is of interest, but in considering the 
result shown thereon, due regard must be paid to numbers. In non-State 
Schools, as before stated, only 28,913 children were weighed and measured, 
while in State Schools the number exceeded 187,000. This vast difference 
must affect the r'esult : — 



Comparative Table showing Weights of Boys and Girls attending 

Non-State Schools. 





Boys. 


Girl's. 


Age. 


Average Weight. 


Advantage 


in Weight. 


Average Weight. 


Advantage in Weight. 




State 


Non-State 


State 


Non-State 


State 


Non-State 


State 


Non-State 




School 


School. 


over 


over 


School 


School 


over 


over 




Boys. 


Boys. 


Non-State. 


State. 


Girls. 


Girls. 


Non-State. 


State. 




lb. 


lb. 


lb. 


lb. 


lb. 


lb. 


lb. 


lb. 


5 


40-48 


40-62 




•20 


39-25 


38-97 


•28 




54 


4112 


42-93 




1-81 


40-42 


41-03 




•61 


6 


43-26 


4411 




•85 


41-94 


42-71 




•77 


64 


45-05 


45-87 




•82 


43-95 


44-72 




•77 


7 


47-33 


47-80 




•47 


46-02 


46-47 




•45 


% 


49-45 


49-66 




•21 


48-25 


47-47 


•78 




8 


51-82 


52-37 




•55 


50-39 


48-22 


2-17 




H 


54-03 


54-14 




•11 


52-74 


51-85 


•89 




9 


56-89 


56-91 


•07 




55-27 


54-57 


•70 




94 


58-80 


58-77 


•03 




58-21 


57-47 


•74 




10 


61-49 


61-46 


•03 




60-75 


60-92 




•19 


104 


53-86 


63-73 


•13 




63-50 


62-97 


•53 




n 


66-53 


66-68 




•15 


66-35 


67-00 




•65 


Ji* 


69-60 


69-41 


•19 




70-42 


70-50 




•08 


12 


72-22 


72-73 


*«.*.. 


•51 


74-34 


74-01 


■33 




124 


75-70 


75-13 


•57 




79-43 


78-58 


•85 




13 


78-59 


80-36 




1-75 


84-59 


84-04 


•55 




134 


83-02 


82-80 


•22 




90-39 


88-70 


1-69 




14 


88-20 


87-63 


■57 




94-07 


93-78 


•29 




144 


9403 


90-76 


3-27 




98-82 


99-38 




•56 


. 15 


99-79 


94-96 


4-83 




102-97 


• 103-74 




•77 


154 


106-29 


102-79 


3-50 




106-00 


106-12 




•12 


16 


11117 


111-32 




•15 


10913 


112-81 




3-68 



Height. — State Schools boys from the age of 5 years until they 
reach 10J are taller than girls, while from then on girls are recorded as 
taller. At non State Schools boys have the advantage in height until 
9 years is reached, that is to say, they lost their position eighteen months 
earlier than State School boys. 

In comparing the heights of State and non-State boys it is shown 
that at the various half years of age the fluctuation is somewhat uniform, 
while in treating with the girls those attending non-State Schools are 
recorded as the tallest. The value of the comparison is, however, 
considerably reduced by the vast difference in numbers examined, 
consequently the result must be taken at its worth. 



so 



The table following will give details of the heights of State and non- 
Stats School girls :— 

Comparative Table showing Height of Boys and Girls attending 
State and Non-State Schools. 





Boy?. 


Girls. 




Average 


Height. 


Advantage 


'•Height. 


Average 


Height. 


Advantage 


inltc'gH. 


Age. 




















State 


Non-State 


State 


Non-State 


State 


Non-State 


State 


Non-S ate 




School 


Sehool. 


over 


over 


School 


School 


over 


over 




Boys. 


Boys. 


Non-State. 


State. 


Girls. 


Girls. 


Non-State. 


State. 




Inches. 


Inches. 


Inches. 


Inches. 


Inches. 


Inches. 


Inches. 


Inches. 


5 


42-05 


42-41 




•36 


41-56 


41-27 


•29 




r A 


42-57 


43-00 




•43 


42-55 


42-62 




■07 


6 


44-07 


44-09 




•02 


43-53 


43-66 




•13 


-6* 


44-97 


45-08 




•11 


44-51 


44-96 




.45 


7 


46-27 


45-88 


•39 




45-63 


45-69 




•06 


n 


46-90 


47- 14 




•24 


46-66 


46-66 






8 


48-00 


48-01 




•01 ' 


47-64 


47-30 


•34 




»i 


48-93 


48-78 


•15, 




48-68 


48-70 




•02 


9 


50-07 


5002 


•05 




49-63 


49-79 




•16 


9£ 


50-99 


50-90 


•09 




50-65 


50-70 




•05 


10 


51-81 


51-26 


•55 




51-59 


51-75 . 




•16 


10J 


52-70 


52-81 




•11 


52-65 


52-66 




•01 


11 


53 64 


53-52 


•12 




53-64 


53-80 




•16 


"J 


54-44 


54-54 




•10 


54-76 


54-78 




•02 


12 


55- 19 


55-50 




•31 


55-79 


55-73 


•06 




12J 


56-12 


56-16 




•04 


56-90 


56-90 




•06 


13 


5719 


57-83 




•64 


5815 


58-26 




•11 


1H 


58-14 


58-15 




•01 


59-22 


59-21 


•01 




14 


59-38 


59-06 


•32 




60-05 


60-20 




•15 


14J 


60-55 


59-95 


•60 




61-00 


61-23 




•23 


15 


61-79 


61-51 


•28 




61-57 


61-24 


•33 




loh 


6318 


63-04 


•14 




61-92 


61-89 


•03 




16 


64-24 


64-90 




•66 


62-2'7 


62-74 




•47 



SUMMARY OF INVESTIGATION. 

The following are the important facts revealed by the foregoing 
tables, &c. :— 

Comparison of heights and weights of boys and girls. 

(a) Boys are heavier than girls between the ages of 5 and 11 years, 

the advantage in their favour being on an average of about 
1 lb. at each half year of age. 

(b) Girls are heavier than boys from 11| to 15 years of age, the 

margin of advantage in the girls favour being on an average 

of about 4 lb. at each half year of age. At 15| and 16 boys 

are again heavier than girls. 

Height. — Boys are taller than girls between the ages of 5 and 10£ 

years, the margin of advantage being on the average of -34 of an inch 

at each half-year of age. At the age of 11 years the average heights of 

boys and girls are al.ke, namely 53*64 inches. At 11| years, however, 

girls become taller than toys and rc'.ain this advantage until they reach 

15 years, the nargin at each half-year of age being about f of an inch. 

At 15-31 and 16 boys are again shown to be taller than girls. 

CDMPARISON OF HEIGHTS AND WEIGHTS OF CHILDREN RESIDING 
IN METROPOLITAN AND COUNTRY DISTRICTS. 

The investigation made along these lines reveals in a very 

pronounced degree that children attending schools in the rural districts 

are of bigger physique than those living in the metropolitan area or in 

large country towns. At all ages the rural children are heavier and 

taller than the city children, while at the same time, although *nofc in 

such a marked degree, they are shown to have the advantage over 

children assembled in large country towns. 



61 



PARENTAGE GROUPS. 

The classification of children into parentage groups has shown 
that children with " Both Australian " parents are both heavier and 
taller than those with parents " One Australian, One Foreign," or 
" Both Foreign," the children of the latter group being the smallest. 

In addition to the above facts some very interesting deductions 
may be made with regard to growth of children at the various ages 
from 5 to 16 years. The following table which has been drawn to show 
the excesses of height and weight of the average child at each year of 
age over the average child a year younger will show clearly details of 
this child development, and from these details the following conclusions 
may be drawn :— 

That boys and girls between the ages of 5 and 6 years show a 
somewhat uniform development both in height and weight. Daring 
that twelve months a girl is shown to grow 2-04 inches, while a boy's 
growth is slightly less, namely 1-96 inches, In weight the increase is — ■ 
boys, 2-S7 lbs. and girls, 2*84 lbs. During the next twelve months, namely, 
between 6 and 7 years, the girl develops more rapidly than the boy in 
height and weight, but for some unknown reason a boy between 7 and 
8 years grows faster than a girl. During the next 5 years of life, namely, 
from 8 to 13, girls develop at a more rapid rate than boys and between 
12 and 13 years they are shown to increase their weight by 10-61 lb\, 
while the boy during that twelve months of life only advances 6| lbs. 
During the same period a girl grows 2-38 inches and a boy 2-04 inches, 
but from 13 to 16 years boys grow at a more rapid rate both in height 
and weight. 

Striking an average and dividing the period 5 to 16 years into 
two groups, namely, from 5 to 13 and 13 to 16, it is shown that during 
the period 5 to 13 the average increase in weight for a boy every twelve 
months is 4vO lb ., while for a girl it is 5-71 lb'. In height the average 
increase for a boy is 1-90 inches, and for a girl 2-08 inches. In the next 
period, 13 to 16, boys show an average yearly increase in weight of 10-84 
lb-., and girls 8-53 lbs., while in height boys grow at an average rate of 
2-37 inches and girls 1-73 inches each year. 

From these figures it is apparent that the periods of child 
growth differ between the sexes, boys commencing their periods of 
accelerated progress between the ages of 12 and 13 years, while girls 
finish their period of a specially fast growth at about the age of 13 years. 

Table showing Details of Chil-.l Development each Year. 







Average I nor 


caao each Year. 


.AgCS. 


Weigi 


t in lbs. 


Heiglit in Inches. 




Boj'i. 


Girls. 


Boys. 


Girls. 


6to 7 „ 


2-87 
3-70 
4-87 
5-03 
4-52 
5-06 
5-74 
C-51 
9-26 
11-06 
12-21 


2-84 
4-04 
4-03 
5-05 
5-59 
5-68 
7-84 
10-61 
9-45 
911 
7-04 


1-96 
1-81 

2-12 
2-07 
116 
1-89 
1-60 
2-04 
2-07 
2-42 
2-62 


2-04 
2-09 
1-96 
2-05 
1 96 
2-05 
2-12 


7to 8 „ 


8to 9 „ 


9tol0 „ 


lOtoll „ 


11 to 12 „ 


12tol3 „ 


2 38 


13tol4 „ 


1-91 


14 to 15 , 


1-42 


15 to 16 „ 


1-88 







14833— F 



82 



COMPARISON WITH STATISTICS ISSUED BY AMERICA AND ENGLAND. 

In certain works dealing with the physical growth of school 
children in the United States and England, and published in the years 
1913 and 1914, tables are given showing the average height and weight 
of children resident in the British Isles and some of the important cities 
in the United States. The tables dealing with English children are 
taken from the report of the Anthropometric Committee of British 
Association, and are said to give the average heights and weights of both 
sexes in the British Isles. The number of children under observation 
is, however, not given. In the case of the American tables the calculations 
have been made by Dr. Franz Boas, from the data of 45,151 boys and 
43,298 girls in the cities of Boston, St. Louis, Milwaukee, Worcester, 
Toronto and Oakland. 

In making comparisons between English, American and Australian 
children due regard must be paid to the fact that different methods appear 
to have been adopted in weighing the children. In England, children have 
been weighed in their ordinary clothes, while in this State the 
weights of the children have been taken after removing all possible 
clothing. It is not clear what method has been adopted by the American 
authorities. The measuring process appears to have been carried out 
on similar lines in all three countries, i.e., children being measured without 
shoes. The following tables will show the average height and weight 
of the three groups of children, and from them it will be seen that English 
children are recorded as being much heavier than the Australian children, 
but that the Australian boys and girls are taller. The difference in weight 
is no doubt accounted for by the different methods adopted in weighing, 
for it must be remembered that the normal child in England weighed in 
the depth of winter fully clothed would necessarily have a distinct 
advantage over a similar child in this country weighed in the middle of 
summer, or even in the depth of winter, seeing that the Australian 
child would have all possible clothing removed. 

The comparison of weights of American and Australian children 
reveals that the average weight of the American boy at each year of age 
is greater than that of the Australian boy, but, strange to say, the 
position is reversed when girls are compared. In height both the girl 
and the boy in this State is recorded as taller than American children. 

It is not possible to compare the English and American child, 
inasmuch as in one case the average height and weight is given at the 
year and the other at the half year of age. 

Table showing Average Height and Weight of British and Australian Boys. 





Average Weight. 


Advantage 

in Weight in 

favour of 

British 

Boys. 


Average Height. 


Advantage 

in Height in 

favour of 

Australian 

Boys. 


Age. 


British 
Boys. 


Australian 
Boys. 


British 
Boys. 


Australian 
Boys. 


5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 


lb. 
39-9 
44-4 
49-7 
54-9 
60-4 
67-5 
72-0 
76-7 
82-6 
920 
102-7 
119-0 


lb. 
40-5 
43-3 
47-0 
51-9 
56-9 
61-4 
66-5 
72-2 
78-8 
88-1 
99-2 
111-4 


lb. 
— -6 
+ 11 

+ 2-7 
+ 3-9 
+ 3-5 
+ 6-1 
+ 5-7 
+ 4-5 
+ 3-8 
+ 3-9 
+ 3-5 
+ 7-6 


Inches. 
41-03 
44-00 
45-97 
47-05 
49-70 
51-84 
53-50 
54-99 
56-91 
59-33 
62-24 
64-31 


Inches, 
42-11 
44-07 
45-88 
48-01 
50-08 
51-74 
53-63 
55-23 
57-27 
59-34 
61-76 
64-38 


Inches. 
+ 1-08 
+ -07 

— -09 
+ -96 
+ -38 

— -10 
+ -13 
+ -24 
+ -36 
+ -01 

— -48 
+ -07 



83 



Table showing Average Height and Weight of British and Australian Girls. 





Average 


Weight. 


Advantage 

in Weight in 

favour of 


Average Height. 


Advantage 
in Height in 


Age. 










favour of 




British 
Girls. 


Australian 
Girls. 


British 
Girls. 


British 
Girls. 


Australian 
Girls. 


British 
Girls. 




lb. 


lb. 


lb. 


Inches. 


Inches. 


Inches. 


5 


39-6 


39-2 


+ .4 


40-82 


41-51 


+ -69 


6 


42-4 


42-0 


+ -4 


42-63 


43-55 


+ -92 


7 


46-7 


46-0 


+ -7 


44-45 


45-64 


+ 1.19 


8 


52-2 


50-1 


+ 2-1 


46-60 


47-60 


+ 1-00 


- 9 


55-5 


55-1 


+ -4 


48-73 


49-65 


+ -92 


10 


62-0 


60-7 


+ 1-3 


51-05 


51-61 


+ -55 


11 


68-1 


66-4 


+ 1-7 


53-10 


53-66 


+ -56 


12 


76-4 


74-2 


+ 2-2 


55-66 


55.78 


+ -12 


13 


87-0 


84-5 


+ 2-5 


57-77 


58-16 


+ -39 


14 


96-7 


940 


+ 2-3 


59-80 


60-07 


+ -27 


15 


104-8 


103-1 


+ 1-7 


60-93 


61-49 


+ -56 


16 


112-7 


110-1 


+ 2-6 


61-75 


62-37 


+ -62 



Table showing '. 


heights and Weights of A 


merican and Australian Boys. 




Average Weight. 


Advantage 

in Weight in 

favour of 

American 

Boys. 


Average Height 


Advantage 
in Height in 


Age. 


American 
Boys. 


Australian 
Boys. 


American 
Boys. 


Australian 
Boys. 


favour of 

Australian 

Boys. 




lb. • 


lb. 


lb. 


Inches. 


Inches. * 


Inches. 


51 


45-2 


45-1 


+ .1 


41-7 


42-6 


+ -9 


U 


45-2 


45-1 


+ -1 


43-9 


44-9 


+ 1-0 


71 


49-5 


49-4 


+ -1 


46-0 


46-9 


+ -9 


81- 


54-5 


54-0 


+ -5 


48-8 


48-9 


+ -1 


91 


59-6 


58-8 


+ -8 


50-0 


50-9 


+ -9 


101 


64-5 


63-8 


+ -7 


51-9 


52-7 


+ -8 


HI 


70-7 


69-5 


+ 1-2 


53-6 


54-4 


+ -8 


12J 


70-9 


75-6 


+ 1-3 


55-4 


56-1 


+ -7 


■ 13J 


84-8 83-1 


+ 1-7 


57-5 


58-2 


+ -7 


141 


95-2 93-2 


+ 2-0 


60-0 


60-4 


+ -4 


151 


107-4 


105-8 


+ 1-6 


62-9 


63-1 


+ -2 


161 


121-0 


120-6 


+ -4 


64-9 


66-5 


+ 1-6 



Table showing- 


Heights and 


Weights of American and Australian Girls. 




Average 


Weight. 


Advantage 
in Weight in 


Average Height 


Advantage 
in Height in 


Age. 






favour of 






favour of 




American 


Australian 


Australian 


American 


Australian 


Australian 




Girls. 


Girls. 


Girls. 


Girls. 


Girls. 


Girls. 




lb. 


lb. 


lb. 


Inches. 


Inches. 


Inches. 


51 








41-3 


42-5 


+ 1-2 


Gh 


43-4 


44-0 


+ -0 


43-3 


44-5 


+ 1-2 


71 


47-7 


48.1 


+ -4 


45-7 


46-6 


+ -9 


81 


52-5 


52-6 


+ .1 


47-7 


48-6 


+ -9 


91 


57-4 


58-1 


+ -7 


49-7 


50-6 


+ -9 


101 


62-9 


63-4 


+ -5 


51-7 


52-6 


+ -9 


111 


69-5 


70-4 


+ -9 


53-8 


54-7 


+ -9 


m 


78-7 


79-3 


+ -6 


56-1 


56-9 


+ -8 


131 


88-7 


90-1 


+ 1-4 


58-5 


59-2 


+ -7 


141 


98-3 


98-9 


+ -6 


60-4 


61-0 


+ -6 


151 


106-7 


106-0 


— -7 


61-6 


61-9 


+ -3 


161 


112-3 






62-2 







84 



TABLES SHOWING ANTHROPOMETRIC DETAILS. 



BOYS. 
Table showing Heights and Weights of Boys attending State and Non-State Schools. 



Age. 


Numbir. 


Average 

Weight 
in lbs. 


Average 

Height 

in inches. 


T 

Increase over 
preceding Half-year. 


Weight 
per 
inch. 


Increase 
over preceding 




Weight. Height. 


Half-year. 


n 


410 


39-43 


41-60 






■947 




5 


1,230 


40-50 


4211 


1-07 


•51 


•957 


•010 


5i 


2,929 


41-34 


42-63 


■84 


•52 


•909 


•012 


G 


3,900 


43-37 


44-07 


203 


1 14 


•984 


•015 


61 


5$07 


45-15 


44-9 3 


1-78 


•91 


1-003 


•019 


7 


6.070 


47-04 


45-88 


1-89 


•90 


1-025 


•022 


71 


G,36Q 


<:9-47 


4-693 


243 


10 J 


1-0 4 


•029 


8 


7,171 


51-91 


48-01 


2-05 


1-08 


1-081 


•029 


6ft 


6,500 


54-04 


48-91 


2-13 


•90 


1-104 


•023 


9 


7,174 


50-97 


50-08 


2-93 


117 


1-137 


•033 


9ft 


0,813 


58-81 


50-98 


1-84 


•90 


1-153 


■016 


10 


0,902 


01-49 


51-74 


2-08 


•70 


1188 


•035 


101 


0,540 


63 84 


52-72 


2-35 


•98 


1-211 


•023 


11 


6,370 


66-55 


5303 


2-71 


•91 


1-241 


•030 


111 


6,441 


69-58 


54-45 


3-03 


•82 


1-277 


•03G 


12 


6,009 


72-29 


55-23 


2-71 


•78 


1-308 


•031 


12V 


f,22 3 


75-05 


50-12 


3-30 


•39 


1-3:7 


•039 


13 


5,758 


78-80 


57-27 


3-15 


115 


1-370 


•029 


13J 


5,120 


83-18 


58-23 


4-38 


•90 


1-428 


•052 


14 


3,379 


88-16 


59-34 


4-98 


111 


1-485 


•057 


US 


2,248 


93-20 


00-48 


5-04 


114 


1-541 


•056 


15. 


1,144 


19-22 


61-76 


G-:2 

■ 


1-23 


1-G. 6 


•065 


151 


585 


105-80 


63-17 


58 


1-41 


1-674 


•068 


10 


420 


111-43 


64-38 


5-03 


1-21 


1-730 


•056 


161 


190 


120-69 


66-50 


9-26 


212 


1-814 


•084 


17 


100 


12722 


66-53 


0-53 


•03 


1-912 


•098 


17i 


57 


128-81 


66-95 


1-59 


•42 


1-941 


•029 


18 


24 


135-83 


08-33 


7-02 


1-38 


1-984 


•043 



85 



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Proportionate Distribution in eucli Age Group, according to Height,, in Inches. {Sie G a^lis.) 

Metropolitan — Boys. 























Ag 


es in Half-years. 
























Height in 
















































inches. 








1 














1 


















' 


1 










5 


5J 


1 6 

1 


I 6J 


7 


7J 


8 


s* 


9 


9J 


i 10 


10} 


11 


111 


12 


12} 


13 


1-3J 


14 


141 


15 J 

1 


15} 


16 


10} 


34 inches.. 




It 


_ 


9 






























| 












35 




14 








" 8 


" 7 


















— 






.. 












36 „ 


96 


11 


"22 


36 


22 


ts 


11 












v ■ 












._ 












37 „ 


16) 


70 






15 


8 


29 




































33 


353 


158 


"57 


"l8 


22 




20 




































39 


838 


590 


80 


72 


22 


" 8 




15 


































40 


1,620 


812 


404 


99 


75 


54 


37 


15 


15 


" 8 


" 8 




























41 


1,902 


1,710 


1,0 3 


45« 


16') 


• 3< 


7 


38 


22 




17 


" 8 


























42 „ 


2,022 


2,172 


1.77) 


908 


53 i 


207 


l.->:i 


33 


30 


" 8 


17 




























43 „ 


1,315 


1,943 


2,159 


1.745 


1,020 


483 


26; 


101 


67 


42 


33 


" 8 




18 




.] 


"lO 


13 




'.'. 










44 


708 


1,218 


1,96.) 


1,010 


1,453 


97" 


518 


131 


82 


63 


17 




25 






9 






.. 












45 „ 


431 


732 


1,3*8 


1,898 


1,860 


1,523 


1)36 


530 


210 


76 


50 


25 




" 9 










14 


"21 










48 ,, 


352 


224 


691 


1,313 


1.613 


1,813 


1,3.'* 


993 


6W 


187 


153 


63 


25 


1< 


"l8 


" 9 




25 














47 


64 


140 


208 


761 


1,275 


1,744 


1.537 


1,169 


1,03' 


595 


301 


136 


75 


Is 


Is 




"lO 




"28 










,, 


48 


32 


70 


162 


4 '4 


1,162 


1,590 


1,709 


1,766 


1.334 


1,098 


639 


•281 


195 


10:, 


83 


"l3 


30 


1. 






"74 








49 „ 






80 


189 


37. 


770 


1,577 


1,626 


1.77M 


1,515 


1,134 


573 


518 


240 


12:1 


65 


20 


13 




"24 










50 „ 




i4 


11 


54 


157 


4.0 


854 


1,330 


1,696 


1,707 


1,367 


1,156 


736 


4311 


2)6 


132 


51 


25 


71 


48 










61 




23 


11 


63 


112 


216 


509 


855 


1,331 


1,530 


1,731 


1.6U6 


1,354 


721 


526 


275 


173 


126 


99 


73 








200 


52 „ 




14 




36 


22 


77 


228 


453 


777 


1,394 


1,519 


1,338 


1,437 


1,203 


1,034 


6:!3 


314 


227 


99 




"74 








53 








S 




33 


44 


327 


401 


824 


1,350 


1,572 


1,737 


1,661 


1,593 


973 


56) 


373 


263 


124 


75 








54 „ 






"ll 




'.'. 


31 


44 


87 


261 


424 


737 


1,233 


1,420 


1,490 


1,469 


1,523 


1,08; 


7(3 


451 


10:) 




205 




4u0 


55 










■ ■ 


v 


7 


46 


90 


272 


459 


505 


1,078 


1,518 


1.5S0 


1,03) 


1,103 


959 


64< 


315 


187 


63 


10 




58 








" 9 


15 




22 


15 


67 


138 


167 


433 


673 


1,011 


1,237 


1, 148 


1,635 


1,1:36 


972 


445 


22) 


63 


_ 


200 


57 












"li. 




7 


22 




103 


203 


414 


690 


837 


1,276 


1,361 


1,375 


1,056 


817 


298 


68 


200 




63 












8 






37 




33 


42 


125 


303 


508 


767 


1,077 


1,500 


1,266 


767 


821 


342 


3M 




59 














" 7 


"21 


7 




8 


51 


67 


174 


316 


63. 


873 


946 


1,153 


1,266 


593 


548 


200 


200 


GO „ 














7 


7 




" 8 


17 


17 


25 


96 


156 


266 


080 


857 


859 


965 


970 


616 


900 


600 


61 


















" 7 




.. 






27 


64 


' 151 


437 


592 


901 


916 


1,157 


891 


30' 


400 


62 „ 






















8 






9 


28 


74 


233 


504 


8:7 


916 


1,231 


1,166 


70' 


4i'0 


63 


























"l7 


18 


40 


9 


112 


265 


49) 


769 


1,269 


959 


i,oor 


1,600 


64 „ 


























8 




IS 


47 


71 


202 


307 


863 


1,157 


1,302 


1,30' 


1,400 


65 ,, 


























8 


" 9 






30 


7b 


232 


694 


746 


1,165 


! 1,200 


1,000 


66 „ 


























8 








10 


25 


71 


345 


371 


959 


1,700 


1,00 


67 „ 






































23 


198 


373 


822 


70l 


2,1:00 


68 






























" 9 


" 9 






2S 


74| 225 


6.5 


60' 


800 


69 „ 






































2b 


99 


113 


68 


700 


600 


70 „ 








































24 


37 


68 


100 


600 



Metropolitan— G irls. 



Height in 






















A,' 


>s i.i llilf-ye 


3.T3. 






















inches. 




















































5 


5J 


6 


61 


7 


75 


8 


8} 


9 


9} 


10 


105 


11 


11 J 


12 


12j 


13 


13} 


11 


144 


15 


15! 


li 


11 


80 inches . . 




17 




10 










































31 „ 








10 


" 8 








































82 „ 




17 




10 


21 








































33 „ 








19 










































34 „ 








19 








" 8 


































35 „ 






"27 


10 










































36 „ 


100 


"l7 


It 


•■ 










































37 „ 


353 


34 




28 


"lB 






"8 
























/ . . 










33 „ 


806 


205 


"82 


70 


32 




"8 


8 


































39 „ 


800 


599 


173 


• 


16 


" 9 


S 


8 






" 9 




























40 „ 


1,478 


1,235 


767 


351 


73 


81 


3< 


10 


" 8 


." 9 


9 




























41 „ 


2,420 


1,826 


1.263 


602 


277 


81 


4:1 


32 


17 


9 






"lO 
























42 „ 


1,832 


2,039 


1,946 


1,137 


587 


30! 


in 


65 


31 


19 


" 9 


10 


























43 „ 


1,254 


1,678 


2,083 


1,652 


1,172 


597 


377 


89 


SO 


23 


3', 


20 


11 




"ll 




















44 ., 


538 


1,131 


1,586 


1,988 


1,58) 


1,119 


740 


2)2 


190 


40 


35 


20 






11 




















45 ,, 


134 


702 


1,200 


1,795 


2,011 


1,802 


1,016 


603 


33) 


131 


62 


31 


"30 






11 


















46 „ 


179 


411 


433 


1,118 


1,807 


1,919 


1,731 


1,000 


539 


431 


100 


61 


10 


"l2 




11 


"l2 
















47 „ 


45 


154 


247 


545 


1,214 


1,422 


1,531 


1,6)0 


1,152 


673 


374 


1.11 


110 


47 




11 


4) 


13 














48 „ 




17 


96 


411 


036 


1,287 


1,917 


1,903 


1,73 5 


1,0!.) 


81' 


424 


210 


107 


"41 


21 


12 


13 














49 „ 




17 


27 


95 


318 


751 


1,011 


1,402 


1,810 


1,318 


1,131 


657 


520 


151 


13! 


43 


49 


20 


"l3 












60 „ 






14 


07 


131 


312 


681 


1,202 


1,516 


1.617 


1,575 


1,172 


80) 


372 


255 


151 


49 


•!■ 




.. 










51 „ 






27 




33 


218 


335 


7H> 


1,039 


1,702 


1.743 


1,637 


1,230 


815 


377 


41) 


123 


91 


31 


31 


"41 




121 




62 „ 




"34 




"23 


16 


50 


107 


3)8 


745 


1,302 


1,338 


1,677 


1,4 


1,193 


8)0 


432 


in 


132 


30 


31 








227 


63 „ 








23 


10 


25 


40 


187 


459 


806 


l,O0fa 


1,411 


1,710 


1,423 


1,211 


627 


421 


3 


103 




"si 








54 „ 












9 


10 


103 


121 


410 


635 


1.010 


1,240 


1,678 


1,245 


1,417 


6M 


312 


308 


9! 










55 „ 




17 








f) 




81 


52 


225 


401 


707 


90) 


1,452 


1,615 


919 


913 


495 


391 


121 


"st 






2-'7 


56 „ 










8 




21 


16 


43 


Oi 


211 


405 


00) 


851 


1,222 


1,2)3 


932 


731 


43L 


311 


81 






227 


57 „ 
















3 


28 


5'. 


19i 


2-13 


36) 


761 


1,017 


1,293 


1,165 


1,20) 


7',t 


4!1 


32! 


320 


211 


227 


53 „ 










" 8 




" 8 


8 


17 


37 


4" 


131 


250 


550 


615 


1,0.1! 


1,40) 


1,435 


1.30) 


Si) 


857 


56) 


38! 


455 


69 „ 














8 




8 


9 


3 


40 


9) 


223 


612 


9)3 


1,215 


1,133 


1,511 


1,52! 


816 


561 


48! 




60 „ 










" 8 








8 


13 


17 


Gl 


90 


20.3 


311 


638 


1,019 


1,211 


1,611 


1,551 


1.33S 


1,230 


1,031 


1,817 


61 „ 














8 








8 


11 


51 


95 


133 


367 


730 


1,187 


1,2)1 


1,52! 


1,6 U 


1,121 


1,56) 


1,590 


62 „ 
















\\ 












13 


100 


1)1 


503 


701 


916 


1 3!7 


1,6)1 


3,120 


1,927 


682 


63 „ 


























21 


12 


5'i 


1(1 


271 


432 


685 


81' 


1,208 


1,2)0 


1, 415 


1,364 


61 „ 


























20 






32 


12! 


26' 


3 


77'. 


930 


1,010 


1.031 


1.137 


65 „ 




























•• 


2! 




37 


HI 


126 


372 


3!6 


560 


1,2)5' 


455 


68 „ 


























"lO 


12 


41 


"21 


25 


26 


72 


62 


214 


18' 1 


302 


1,137 


67 „ 


































12 




13 


62 


16 "1 




121 


455 


68 „ 






































•• 


- 


122 


"80 


1 





In the above Tables the actu:il figures at each age have bocn re listributed for a thcirelicJ total of 1 1,000 at each ajy.\ This rrolucc3 a strictly comparable 
proportionate distiibution. 



93 



Percentage Incria^fs over Preceding Year. 
All Boys and All Girls, in half-years and in years— Weight. (See Graph.) 

Boys. GhU. 



Years. 



41 
5 

6 

6-1 

7 

14 

8 

> c l 

9 

91 

10 

104 

ii 
i'l 

12 

124 

13 

131 

14 

15 

154 

16 

164 

17 

174 

18 



Average 
Weight. 



39 43 

40-50 
4134 
43 37 
4515 
47-01 
49-47 
51-91 
54-04 
5697 
58 81 
61-49 
6 J 84 
03 55 
695S 
7-2-29 
75'65 
78-80 
83- 18 
88 16 
93 20 
93-22 
1058 
111-43 
120 69 
127-22 
1-28-81 
135-83 



Difference. 



Half-year. Year. 



107 
■81 

2 0? 
1-78 
1-89 
243 
2 65 
2 13 
2 9! 

1 84 

2 68 
2-35 
271 
30! 
2-71 
33(3 
315 
4-38 

4 98 

5 04 

6 02 
6 58 

5 63 
9 26 

6 53 
1-59 
7-02 



2 87 
3-67 
503 
506 



4 52 



5 06 
5-74 
651 

9-ae 

lice 

12-21 



1579 



Percentage 
Increment. 



Half- ear 



Year. 



8G1 







39 33 






39 21 


20 




4048 


4-9 


70 


42 i'5 


4-1 




44 05 


40 


S-4 


46 09 


5 1 




48 15 


53 


10 7 


50- 12 


41 




52-63 


5 4 


9-7 


55-17 


3-2 




rs-n 


4 5 


7-9 • 


CO 76 


3-8 




63 42 


4 2 


8-2 


66 41 


4-5 




70-45 


39 


8 6 


74 28 


4-6 




79-30 


4-0 


90 


84-49 


5-5 




9012 


6-0 


11-8 


94 03 


5-7 




98 93. 


6-4 


12 5 


103- 14 


C-J 




106 03 


5 3 


12 


11018 


8 3 






5-4 


14 




12 






54 


67 





Difference 



A\ erase 
Weight. 



Percentage 
In renient. 



Half year | Year. 



Half-year, 



•15 

1 27 
157 
200 
201 

2 06 
1-9. 
2 51- 
2 54 

2 91 
265 
2-66 

3 02 
3 99 
3-85 
5 02 
5 19 
5-63 
391 
4-90 
421 
2-89 
4-15 



2-81 

4 04 
4-03 

5 05 
5 59 
5-6S 
7-84 

10-21 
954 

9-ii 

7 04 



3-2 
3-8 
47 

4 6 
4-4 
41 
50 
50 

5 3 
4 5 

4 3 
47 

6 

5 4 
67 
65 
66 
4 3 
52 
4 2 
2-8 
39 



Year. 



71 

9-6 

"87 

10 

'io-i 

"9-3 

i is 

137 
11-2 

-96 

"6 9 



Percentage Increases on Previous Year. 
All Boys and All Girls, in half-years and in years -Height. 



(See Graph.) 



Dry*. 



Girls. 





Average 


Difference. 


Percentage 
Increment. 


Average 


Difference 


Tercentag;) 
Increment. 


Years. 


Height. 










Height. 














Half-year. 


Year. 


Half-year. 


Year. 




Half-year. 


Ytar. 


Half-year. 


Year. 


n 


.41-6 










41-10 










5 


4211 


•51 




•12 




4151 


•41 




•09 




51 


42 63 


•52 




12 




42-56 


1 03 




•25 




6 


4107 


1-44 


196 


•31 


•46 


4355 


■99 


2-04 


-23 


•49 


6i 


4498 


•91 




•20 




44 57 


•93 




•22 




7 


45 88 


90 


1 SI 


■20 


•41 


45 64 


1-07 


2-05 


•24 


•47 


7* 


46 93 


105 




•23 




4366 


102 




•22 




8 


48-01 


1 OS 


2 13 


•23 


•46 


47 CO 


■94 


1 96 


■20 


•43 


81 


48-91 


•90 




•18 




48 68 


103 




•22 




9 


50-08 


117 


2 07 


"24 


•43 


49 65 


97 


2 05 


•20 


•43 


9* 


50-08 


•90 




•18 




50-68 


1 01 




•20 




10 


51-74 


•76 


I 66 


•15 


31 


51-61 


•95 


i-96 


•18 


■40 


10* 


52-72 


■98 




•19 




52-65 


104 




•20 




11 


53-63 


■91 


1-89 


•17 


•30 


53 66 


101 


205 


•19 


.39 


m 


54 45 


•82 




•15 




5476 


110 




20 




12 


55 23 


•78 


1-60 


•14 


•30 


55-78 


102 


2- 12 


•18 


•39 


12.1 


56-12 


•89 




•16 




56-91 


113 




•20 




13 


57-27 


1-15 


2 '04 


•20 


■37 


53 16 


1-25 


2-38 


•22 


•42 


13* 


58-23 


•96 




•16 




59-22 


106 




■18 




It 


5934 


111 


2 07 


•19 


•36 


60 07 


•85 


1-91 


14 


•32 


14* 


60-48 


114 




•19 




61-01 


•97 




•16 




15 


6176 


1-28 


2 42 


•21 


•41 


6149 


•45 


1-42 


•07 


•25 


15* 


63 17 


1-41 




•22 




6191 


•42 




•03 




16 


64-38 


1 21 


2 62 


■19 


■42 


62-37 


•40 


•88 


•07 


14 


16.V 


66-50 


2 12 




•32 














17 


66-53 


■03 


2 15 


•00 4 


■33 












17* 


66 95 


42 




•06 














18 


68 33 


1-38 


1-80 


■20 


•27 













[1 p a g e photo, blocks, 13 graphs ( 1 folding \] 



SYDNEY : 
WILLIAM APPLEGATE GULLICK, GOVERNMENT PRINTER. 

1921. 



so- 



lffi™SLiP F CONGRESS 7 



,0 029 483 052 2 



